Contract Details
Ancillary Care Services
Facility name
Community Oxygen & Medical Equipment
Provider ID
P000004287
NPI
1326114356
Tax ID
611085581
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
603 West Everly Brothers Boulevard
Central City, KY 42330
United States
County
Muhlenberg
Phone
2707543187 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address