Contract Details
Breath of Life Home Oxygen Ltd Inc
Facility name
Breath of Life Home Oxygen Ltd Inc
Provider ID
P000006622
Tax ID
752905042
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
2414 US Hwy 80 Suite 409
Mesquite, TX 75149
United States
County
Dallas
Phone
8176861111 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address