Contract Details
Ancillary Care Services
Facility name
Cardiosom of Noblesville
Provider ID
P000003842
NPI
1114937893
Tax ID
113733629
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
17527 River Road
Noblesville, IN 46062
United States
County
Hamilton
Phone
3172193360 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address