Healthcare Provider Details

I. General information

NPI: 1386816890
Provider Name (Legal Business Name): TEAM ADAPTIVE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HARRISON AVE
PANAMA CITY FL
32401-2432
US

IV. Provider business mailing address

978 TOMMY MUNRO DR
BILOXI MS
39532-2130
US

V. Phone/Fax

Practice location:
  • Phone: 850-522-0059
  • Fax: 850-522-0520
Mailing address:
  • Phone: 228-388-5700
  • Fax: 228-385-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTTY L SCHONEWITZ
Title or Position: CEO/OWNER
Credential:
Phone: 228-388-5700