Contract Details
Ancillary Care Services
Facility name
Fred Toenges Shoes & Pedorthics
Provider ID
P000006110
Tax ID
350712380
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
4311 West Clara Lane
Muncie, IN 47304
United States
County
Delaware
Phone
7652897105 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address