Organization
180 MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY B HENDRIX (CFO)
(405) 443-2985
Entity
Organization
Contact information
Practice address
717 ATANDO AVE, SUITE J, CHARLOTTE, NC 28206-1915
(980) 207-1156
(888) 718-0633
Mailing address
8516 NW EXPRESSWAY, OKLAHOMA CITY, OK 73162-6010
(877) 688-2729
(888) 718-0633
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
02000
NC
332BC3200X
Customized Equipment (DME)
02000
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7705118
—
NC
05
—
DE2916
—
SC
Enumeration date
11/18/2009
Last updated
05/18/2022
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