Contract Details
Facility name
Home Medical Equipment
Provider ID
P000005471
NPI
1851389647
Tax ID
300224091
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
112 Dennis Drive
Lexington, KY 40503
United States
County
Fayette
Phone
8592774663 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address