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Contract Details
Pomac Prosthetic & Orthotic Management
Facility name
Greenseasons
Provider ID
P000006392
Tax ID
113154194
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
1440 East Gun Hill Rd
Bronx, NY 10469
United States
County
Bronx
Phone
7183251123
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address