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Contract Details
Ancillary Care Services
Facility name
Academy/P&O Care Centers
Provider ID
P000006171
Tax ID
113193924
Effective Date
4/1/2012
Last Updated
10/16/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
319 South Main Street
Salisbury, NC 28144
United States
County
Rowan
Phone
8006692672
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address