=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407103013
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NABLE CONTRACTING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2012
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1393 LONDON BRIDGE RD STE 103
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23453-3125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-270-4239
-----------------------------------------------------
Fax | 757-961-3298
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1393 LONDON BRIDGE RD STE 103
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-270-4239
-----------------------------------------------------
Fax | 757-961-3298
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LES SIMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-289-3334
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 2705147969
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------