Provider Demographics
NPI:1104123710
Name:NUBIANSOFT, LLC
Entity type:Organization
Organization Name:NUBIANSOFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISHMAEL
Authorized Official - Middle Name:LATEEF
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-885-8755
Mailing Address - Street 1:5130 S FORT APACHE RD
Mailing Address - Street 2:#215-136
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1719
Mailing Address - Country:US
Mailing Address - Phone:702-885-8755
Mailing Address - Fax:
Practice Address - Street 1:5130 S FORT APACHE RD
Practice Address - Street 2:#215-136
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1719
Practice Address - Country:US
Practice Address - Phone:702-885-8755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty