Contract Details
Ancillary Care Services
Facility name
CPAP Care Club
Provider ID
P000004094
NPI
1245221092
Tax ID
203215567
Effective Date
4/1/2012
Last Updated
9/26/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
28 White Bridge Road
Nashville, TN 37205
United States
County
Davidson
Phone
8004875566 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address