180 MEDICAL, INC. (NPI# 1063749042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063749042 |
| Entity Type | Organization |
| Organization Name | 180 MEDICAL, INC. |
| Practice Address |
1520 N Hearne Ave Suite 112 Shreveport LA 71107-7155 |
| Mailing Address |
8516 Nw Expressway Oklahoma City OK 73162-6010 |
| Practice Telephone | 3187984977 |
| Practice Fax Number | 8887180633 |
| Mailing Telephone | 8776882729 |
| Mailing Fax Number | 8887180633 |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2019-08-08 |
| Authorized Official Name | MR. JEFFERY B HENDRIX (CFO) |
| Authorized Official Telephone | 4054432985 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | DME.000354 | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1016501 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518426204 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 5756 W 74th Street, Bldg 112, Indianapolis, IN 46278-1755 | 2019-03-13 |
| 1841785888 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 5324 W Reno Ave Ste A, Oklahoma City, OK 73127-6359 | 2018-06-22 |
| 1831563238 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 5620 San Francisco Rd Ne Ste A, Albuquerque, NM 87109-4656 | 2015-11-23 |
| 1831504984 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 7869 Sw Nimbus Ave, Space 29-e, Beaverton, OR 97008-6404 | 2014-06-27 |
| 1326327115 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9050 Parkhill St, Lenexa, KS 66215-3536 | 2011-08-10 |
| 1538452628 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 5175 Elmore Rd, Suite 18, Memphis, TN 38134-5629 | 2011-05-23 |
| 1609104736 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 2830 Horace Shepard Dr, Suite 2, Dothan, AL 36303-1007 | 2009-12-01 |
| 1902134570 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | N8w22195 Johnson Dr, Suite 100, Waukesha, WI 53186 | 2009-11-19 |
| 1265760920 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 717 Atando Ave, Suite J, Charlotte, NC 28206-1915 | 2009-11-18 |
| 1073841730 | 180 Medical, Inc. | Durable Medical Equipment & Medical Supplies | 10707 Mockingbird Dr, Omaha, NE 68127-1941 | 2009-11-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | 180 MEDICAL, INC | 8516 Nw Expressway, Oklahoma City, OK 73162 |
| New York State Corporations | 180 MEDICAL, INC. | 80 State Street, Albany, Ny 12207 |
| Connecticut Business Registrations | 180 MEDICAL, INC. | 5324 West Reno, Suite A, Oklahoma City, OK 73127 |
| Iowa Business Entities | 180 MEDICAL, INC. | 8516 Nw Expressway, Oklahoma City, OK 73162 |
| Vermont Business Registrations | 180 MEDICAL, INC. | 8516 Nw Expressway, Oklahoma City, OK 73162 |
| Oregon Corporations, Companies and Business Names | 180 MEDICAL, INC. | 8516 Nw Expressway, Oklahoma City, OK 73162 |
| Indiana Business Entities | 180 MEDICAL, INC. | 5324 West Reno, Suite A, Oklahoma City, OK 73127-6359 |
| Street Address |
1520 N HEARNE AVE SUITE 112 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71107-7155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992912380 | Eastgate Chiropractic Clinic, Inc | Chiropractor | 1520 N Hearne Ave, Suite 103, Shreveport, LA 71107-7155 | 2007-05-17 |
| 1124653944 | Silas T Jennings | Chiropractor | 1520 N Hearne Ave, Shreveport, LA 71107-7155 | 2020-03-12 |
| 1760691281 | Chad Richard Havard | Chiropractor | 1520 N Hearne Ave, Suite 103, Shreveport, LA 71107-7155 | 2007-05-21 |
| 1346457736 | Dwight V Hart | Chiropractor | 1520 N Hearne Ave, Suite 103, Shreveport, LA 71107-7155 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490875 | Kimber Leigh Lumley | Registered Nurse | 1440 Hawn Ave., Shreveport, LA 71107 | 2019-08-01 |
| 1871063461 | Nicole Capito | Case Manager/Care Coordinator | 200 North Thomas Drive Ste 1, Shreveport, LA 71107 | 2018-11-27 |
| 1891260899 | Danielle Leigh Dreher | Dental Assistant | 3610 Gorman Rd, Shreveport, LA 71107 | 2018-10-05 |
| 1255817540 | Shirley Marie Washington | Technician | 3227 Old Mooringsport Rd., Shreveport Rd, LA 71107 | 2018-07-19 |
| 1366928467 | Katrina L Bailey | Case Manager/Care Coordinator | 1111 Hawn Ave Apt A, Shreveport, LA 71107 | 2018-07-12 |
| 1063907970 | James Mcneely IIi | Public Health or Welfare | 5922 Alaska Ln, Shreveport, LA 71107 | 2018-06-25 |
| 1528560067 | Jacarie Guice | Case Manager/Care Coordinator | 4601 N. Market Ste 2, Shreveport, LA 71107 | 2018-03-01 |
| 1467971069 | Tracy Renard Harris | Counselor | 1149 Englemeade Dr, Shreveport, LA 71107 | 2017-09-14 |
| 1427588045 | Mark Rogers | Behavior Technician | 1500 N. Market Unit C Suite 105, Shreveport, LA 71107 | 2017-06-15 |
| 1356871164 | Hope4youth | Voluntary or Charitable | 2850 King Oaks Loop, Shreveport, LA 71107 | 2017-06-14 |
| Find all providers in zip 71107 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093325854 | Morning Star Medical | Durable Medical Equipment & Medical Supplies | 456 W 61st St, Shreveport, LA 71106-2511 | 2020-08-06 |
| 1982253340 | Total Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 333 Texas St Ste 1111, Shreveport, LA 71101-5303 | 2019-09-09 |
| 1548611288 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 9484 Ellerbe Rd Ste 100, Shreveport, LA 71106 | 2016-06-23 |
| 1750730057 | Louisiana Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 10460 Norris Ferry Rd, Shreveport, LA 71106 | 2016-06-07 |
| 1396117735 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 4701 Northport Blvd, Shreveport, LA 71107 | 2015-10-26 |
| 1437521879 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 412 Bert Kouns Industrial Loop, Shreveport, LA 71106-8127 | 2015-10-26 |
| 1871905992 | Tap-alert | Durable Medical Equipment & Medical Supplies | 3305 W 70th St Unit D, Shreveport, LA 71108-4609 | 2014-05-23 |
| 1558709279 | Nla Medical LLC | Durable Medical Equipment & Medical Supplies | 8125 Captain Mary Miller Dr, Shreveport, LA 71115-2982 | 2013-06-05 |
| 1225381981 | Med Health Depot, LLC | Durable Medical Equipment & Medical Supplies | 6658 Youree Dr, Suite 180 #298, Shreveport, LA 71105-4648 | 2012-10-18 |
| 1902176142 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 9510 Ellerbe Rd, Shreveport, LA 71106-7406 | 2012-01-05 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.