Provider Demographics
NPI:1386354546
Name:180 PHARMA CORP.
Entity type:Organization
Organization Name:180 PHARMA CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGELDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-509-4420
Mailing Address - Street 1:268 BAY RIDGE AVE
Mailing Address - Street 2:APT 02A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220
Mailing Address - Country:US
Mailing Address - Phone:347-203-9612
Mailing Address - Fax:
Practice Address - Street 1:268 BAY RIDGE AVE
Practice Address - Street 2:APT 02A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:347-203-9612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy