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General NPI Number Information
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NPI Number | 1558896498
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Entity Type | Organization
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Legal Business Name | NOAH ASSOCIATES INCORPORATED
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 10501 W GREENFIELD AVE
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City | WEST ALLIS
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State | WI
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Zip | 53214-2421
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Country | US
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Telephone | 414-600-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 10501 W GREENFIELD AVE
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City | WEST ALLIS
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State | WI
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Zip | 53214-2421
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JUSTIN HANSON
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Credential |
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Telephone | 414-600-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 52D2127517
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License Number State | WI
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