Organization Active NPI

Noble Care Inc

Doing business as Noble Ambulance Inc

  • Land Ambulance
  • Clackamas, OR
National Provider Identifier
1104819507
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
0322-06 Issued in OR
Legal business name
NOBLE CARE INC
Doing business as
Noble Ambulance Inc
Practice address
15140 SE 82ND Dr
Suite 270
Clackamas, OR 97015-9695
Phone
(503) 742-1692
Fax
(503) 742-1693
NPI assigned
Aug 31, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Manny Clair Polanco
Title
President
Phone
(503) 742-1692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 0322-06 OR Primary

Addresses

Primary practice location

15140 SE 82ND Dr
Suite 270
Clackamas, OR 97015-9695

Mailing address

PO Box 2917
Clackamas, OR 97015-2917
Phone (503) 742-1692

Other identifiers 2

IdentifierTypeStateIssuer
182226MedicaidOR
295445MedicaidOR

Other names 1

  • Noble Ambulance Inc Doing business as

National Provider Directory

National Provider Directory

Locations

15140 SE 82nd Dr
Ste 270
Clackamas, OR 97015
Phone (503) 742-1692

411 SE 81st Ave
Portland, OR 97215
Phone (503) 254-7006

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104819507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2917",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970152917",
            "telephone_number": "503-742-1692",
            "fax_number": "503-742-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15140 SE 82ND DR",
            "address_2": "SUITE 270",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159695",
            "telephone_number": "503-742-1692",
            "fax_number": "503-742-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOBLE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLANCO",
        "authorized_official_first_name": "MANNY",
        "authorized_official_middle_name": "CLAIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-742-1692",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OR",
            "license": "0322-06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182226",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295445",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Noble Ambulance Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.