| Organization Name: | 180 MEDICAL, INC. |
| NPI Number: | 1679866768 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD D HOWELL (COO) |
| Mailing Address: | 207 S 6th St Wood River |
| State: | IL US |
| Postal Code: | 620952345 |
| Phone Number: | 6182163300 |
| Fax Number: | 8887180633 |
| NPI Enumeration Date: | 05/23/2011 |
| NPI Last Update Date: | 10/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 203.001521 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |