Contract Details
Ancillary Care Services
Facility name
CHS DME
Provider ID
P000005270
NPI
1750523676
Tax ID
113733629
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
13707 North Nebraska Avenue
Tampa, FL 33613
United States
County
Hillsborough
Phone
8139174570 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address