Contract Details
Ancillary Care Services
Facility name
Behrens Southern Comfort Medical Supply
Provider ID
P000003681
NPI
1043212871
Tax ID
680593433
Effective Date
4/30/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2902 Avenue R 1/2
Galveston, TX 77550
United States
County
Galveston
Phone
4096211167 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address