Contract Details
Ancillary Care Services
Facility name
AHC Network
Provider ID
P000005056
NPI
1669631420
Tax ID
760711606
Effective Date
4/1/2012
Last Updated
10/9/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
12010 Northwest 15th Street
Pembroke Pines, FL 33026
United States
County
Broward
Phone
9548857911 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Urgent Care Facility
Map
Address