Contract Details
Facility name
American Eyecare PC
Provider ID
P000005541
NPI
1881789667
Tax ID
421213277
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2743 Mount Pleasant St
Burlington, IA 52601
United States
County
Des Moines
Phone
3197542020 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address