Contract Details
Ancillary Care Services
Facility name
Advanced Technologies
Provider ID
P000006140
Tax ID
611216681
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
4137 Amberwood Court
Lexington, KY 40513
United States
County
Fayette
Phone
8595784822 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address