Contract Details
Advanced Health Services Inc
Facility name
Advanced Health Services Inc
Provider ID
P000004467
NPI
1407914153
Tax ID
200419015
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1400 Golf Rd Suite 225
Grayslake, IL 60030
United States
County
Lake
Phone
8472314507 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address