Contract Details
Ancillary Care Services
Facility name
Dallas Life Support Systems
Provider ID
P000005329
NPI
1780686998
Tax ID
752434862
Effective Date
4/1/2012
Last Updated
11/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
7440 Whitehall Street
Richland Hills, TX 76118
United States
County
Tarrant
Phone
8172847788 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address