MEDICARE: NOBLE HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HCO-1759	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720599855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOBLE HEALTH LLC

Provider Business Mailing Address
First Line	:	6803 DARBY LN
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-2006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6803 DARBY LN
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-2006
Country	:	US
Telephone Number	:	202-790-8065
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MOHAMED YUSUF ALI
Credential	:
Telephone Number	:	202-790-8065

Provider Enumeration Date	:	10/16/2017
Last Update Date	:	10/16/2017

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Directions to “NOBLE HEALTH LLC ” Practice Location

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