Contract Details
Ancillary Care Services
Facility name
Aerosol Plus
Provider ID
P000005785
NPI
1992760565
Tax ID
204454915
Effective Date
4/1/2012
Last Updated
10/17/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
792 Folly Road
Charleston, SC 29412
United States
County
Charleston
Phone
8437956452 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address