Provider Demographics
NPI:1093792863
Name:02 NEAL MEDICAL, INC.
Entity Type:Organization
Organization Name:02 NEAL MEDICAL, INC.
Other - Org Name:ONEAL MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-989-9902
Mailing Address - Street 1:240 CAHABA VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2212
Mailing Address - Country:US
Mailing Address - Phone:205-989-9902
Mailing Address - Fax:205-989-9903
Practice Address - Street 1:240 CAHABA VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2212
Practice Address - Country:US
Practice Address - Phone:205-989-9902
Practice Address - Fax:205-989-9903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
AL900464332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009925455Medicaid
AL51514676NEOtherBCBSAL
AL4685460001Medicare NSC