Contract Details
Ancillary Care Services
Facility name
American Home Patient
Provider ID
P000004049
NPI
1225037401
Tax ID
710708183
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
5700 South Zero Street Suite 2
Fort Smith, AR 72903
United States
County
Sebastian
Phone
4796496464 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address