Contract Details
Ancillary Care Services
Facility name
Heritage Home Medical Equipment
Provider ID
P000005694
NPI
1952383382
Tax ID
260119443
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3202 Midwestern Parkway Suite 100
Wichita Falls, TX 76308
United States
County
Wichita
Phone
9406873333 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address