NPI Lookup
NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

360 BODY WELLNESS INC
3407 IL STATE ROUTE 157
GLEN CARBON, IL62034
 Phone: 618-288-3610
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for 360 BODY WELLNESS INC

NPI # 1679024228
LBN Legal business name 360 BODY WELLNESS INC
Authorized official PHILIP DUDAK - (FAMILY NURSE PRACTITIONER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/19/2016
Last updated 10/19/2016 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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