Contract Details
Ancillary Care Services
Facility name
Foster Medical Supply
Provider ID
P000004812
NPI
1558394031
Tax ID
650557510
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3911 Southwest 47th Avenue Suite 911
Davie, FL 33314
United States
County
Broward
Phone
9543270196 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address