Provider Demographics
NPI:1558117077
Name:NOBLE HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:NOBLE HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-843-2040
Mailing Address - Street 1:6040 TARBELL RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-1314
Mailing Address - Country:US
Mailing Address - Phone:888-843-2040
Mailing Address - Fax:888-842-3977
Practice Address - Street 1:311 POMONA DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1693
Practice Address - Country:US
Practice Address - Phone:888-743-3204
Practice Address - Fax:743-242-1462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy