Contract Details
Ancillary Care Services
Facility name
Hill's Drug Store
Provider ID
P000005555
NPI
1891744546
Tax ID
741068835
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
705 West Kirk Place
San Antonio, TX 78226
United States
County
Bexar
Phone
2102257283 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address