Contract Details
Ancillary Care Services
Facility name
Aerocare
Provider ID
P000004416
NPI
1396069621
Tax ID
593758015
Effective Date
4/1/2012
Last Updated
10/18/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3931 Mega Drive Suite 11
Myrtle Beach, SC 29588
United States
County
Horry
Phone
8777271651 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address