| Name: | 180 Medical, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Corporation |
| Status: | Exists |
| Date of registration: | 27 Aug 2002 (22 years ago) (Companies founded in August 2002) |
| Entity Number: | 000-943-183 |
| Register Number: | 000943183 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Oklahoma |
| Principal Address: | 5324 WEST RENO STE AOKLAHOMA CITY, OK 73127-6359 |
| Principal Mailing Address: | 4801 S BILTMORE LANEMADISON, WI 53718 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609104736 | 2009-12-01 | 2022-05-18 | 8516 NW EXPRESSWAY, OKLAHOMA CITY, OK, 731626010, US | 2830 HORACE SHEPARD DR, SUITE 2, DOTHAN, AL, 363031007, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 877-688-2729 |
| Fax | 8887180633 |
| Phone | +1 334-803-8135 |
Authorized person
| Name | MR. JEFFERY B HENDRIX |
| Role | CFO |
| Phone | 4054432985 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 946 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 006616600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 129293 |
| State | AL |
| Issuer | MEDICAID |
| Number | 300801390A |
| State | GA |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
