Contract Details
Area Wide Medical, Inc
Facility name
Area Wide Medical, Inc
Provider ID
P000005062
NPI
1679519888
Tax ID
752721641
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
3711 19th St
Lubbock, TX 79410
United States
County
Lubbock
Phone
8068946551 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address