Contract Details
Ancillary Care Services
Facility name
Columbia Medical Equipment
Provider ID
P000004050
NPI
1225038730
Tax ID
611157887
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
2991 Campbellsville Road
Columbia, KY 42728
United States
County
Adair
Phone
2703845143 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address