Contract Details
Breath E Z Health Care
Facility name
Breath E Z Health Care
Provider ID
P000003934
NPI
1164427100
Tax ID
752951754
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
400 Southeast 1st St
Mineral Wells, TX 76067
United States
County
Palo Pinto
Phone
9403251112 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address