Contract Details
Ancillary Care Services
Facility name
Arcadia H.O.M.E.
Provider ID
P000003969
NPI
1184640393
Tax ID
593758015
Effective Date
4/1/2012
Last Updated
10/18/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
406 Bells Highway
Walterboro, SC 29488
United States
County
Colleton
Phone
8435499600 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address