Contract Details
Facility name
Duramart Medical Supplies, Inc
Provider ID
P000004441
NPI
1396922589
Tax ID
261536180
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
8034 Culebra Suite 114
San Antonio, TX 78251
United States
County
Bexar
Phone
2105214200 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address