Contract Details
Ancillary Care Services
Facility name
Hi-Tech Healthcare
Provider ID
P000005285
NPI
1760492300
Tax ID
581897161
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
718 Cherokee Street Northeast
Marietta, GA 30060
United States
County
Cobb
Phone
7707920030 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address