Contract Details
Ancillary Care Services
Facility name
Accucare Medical Equipment
Provider ID
P000004848
NPI
1568783710
Tax ID
800002984
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2150 Central Avenue
Augusta, GA 30904
United States
County
Richmond
Phone
3039058527 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address