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Contract Details
Facility name
Hometown Medical Equipment
Provider ID
P000002200
NPI
1780646307
Tax ID
320044462
Effective Date
7/15/2006
Last Updated
3/4/2022
Direct Contract
Yes
Term Date
2/28/2022
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
80 North Forest Avenue
Luverne, AL 36049
United States
County
Crenshaw
Phone
3343356599
(
Phone
)
Billing Details
Address
80 North Forest Avenue
Luverne, AL 36049
Billing Phone
3343356599
Specialty Type
Durable Medical Equipment & Medical Supplies
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