Contract Details
Ancillary Care Services
Facility name
Diabetes Care Club
Provider ID
P000005177
NPI
1710913173
Tax ID
731628560
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
6840 Carothers Parkway Suite 600
Franklin, TN 37067
United States
County
Williamson
Phone
6152262221 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address