Contract Details
Ancillary Care Services
Facility name
Beacon Hospice
Provider ID
P000004936
NPI
1609902410
Tax ID
205768779
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
5016 Gilmer Road
Longview, TX 75604
United States
County
Gregg
Phone
9035530035 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Hospice
Map
Address