Provider Demographics
NPI:1477658904
Name:TEAM ADAPTIVE, INC
Entity Type:Organization
Organization Name:TEAM ADAPTIVE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTTY
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:SCHONEWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-388-5700
Mailing Address - Street 1:978 TOMMY MUNRO DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2130
Mailing Address - Country:US
Mailing Address - Phone:228-388-5700
Mailing Address - Fax:228-385-2237
Practice Address - Street 1:978 TOMMY MUNRO DR
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2130
Practice Address - Country:US
Practice Address - Phone:228-388-5700
Practice Address - Fax:228-385-2237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0668311.1332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0440922Medicaid
MS=========OtherBCBS PROVIDER NUMBER
MS0440922Medicaid
MS=========OtherBCBS PROVIDER NUMBER