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General NPI Number Information
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NPI Number | 1013975929
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Entity Type | Organization
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Legal Business Name | TEAM O'NEILL INC
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10336 W COGGINS DR SUITE B
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City | SUN CITY
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State | AZ
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Zip | 85351-3438
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Country | US
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Telephone | 623-875-6683
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Fax | 623-875-9472
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Provider Business Mailing Address
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Address Line | 10336 W COGGINS DR SUITE B
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City | SUN CITY
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State | AZ
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Zip | 85351-3438
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Country | US
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Telephone | 623-875-6683
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Fax | 623-875-9472
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | WILLIAM T O'NEILL JR.
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Credential | CPO
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Telephone | 623-875-6683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 07660280R
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License Number State | AZ
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