Contract Details
Ancillary Care Services
Facility name
Freedom Respiratory
Provider ID
P000004269
NPI
1316987811
Tax ID
200028861
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1155 Piney Forest Road Suite A
Danville, VA 24540
United States
County
Danville City
Phone
8668369666 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address