Provider Demographics
NPI:1841706389
Name:NOBILITY LLC
Entity type:Organization
Organization Name:NOBILITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAMIS
Authorized Official - Middle Name:
Authorized Official - Last Name:AQEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-793-0131
Mailing Address - Street 1:PO BOX 7370
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23509-0370
Mailing Address - Country:US
Mailing Address - Phone:845-793-0131
Mailing Address - Fax:757-624-2005
Practice Address - Street 1:1015 E PRINCESS ANNE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2832
Practice Address - Country:US
Practice Address - Phone:845-793-0131
Practice Address - Fax:757-624-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA624343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========Medicaid