Contract Details
Ancillary Care Services
Facility name
Georgia Respiratory Home Care & Medical Equipment
Provider ID
P000003642
NPI
1023124898
Tax ID
582505142
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
818 East Robert Toombs Avenue Suite R
Washington, GA 30673
United States
County
Wilkes
Phone
7066782244 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address