Contract Details
Ancillary Care Services
Facility name
Choice Medical
Provider ID
P000003704
NPI
1053314161
Tax ID
460481963
Effective Date
4/1/2012
Last Updated
9/26/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
400 Erin Drive
Knoxville, TN 37919
United States
County
Knox
Phone
8655881643 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address