Contract Details
Ancillary Care Services
Facility name
Griffin Medical Service
Provider ID
P000004322
NPI
1346267366
Tax ID
582178887
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
798 Red Bud Road
Calhoun, GA 30701
United States
County
Gordon
Phone
7066253777 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address