Contract Details
Ancillary Care Services
Facility name
Cardiosom of Spartanburg
Provider ID
P000006410
Tax ID
113733629
Effective Date
4/1/2012
Last Updated
10/17/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1330 Boiling Springs Road Suite 2900
Spartanburg, SC 29303
United States
County
Spartanburg
Phone
8645293460 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address