Contract Details
Ancillary Care Services
Facility name
Aerocare
Provider ID
P000005114
NPI
1689983355
Tax ID
593641476
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1701 Southeast Tiffany Avenue
Port Saint Lucie, FL 34952
United States
County
Saint Lucie
Phone
7723374326 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address