Contract Details
Ancillary Care Services
Facility name
Home Oxygen Medical Equipment of Hernando
Provider ID
P000003883
NPI
1134190002
Tax ID
200686689
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
18819 Sakera Road Suite 11
Hudson, FL 34667
United States
County
Pasco
Phone
8772813326 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address