Contract Details
Ancillary Care Services
Facility name
Huntleigh Home Medical
Provider ID
P000004073
NPI
1235177395
Tax ID
742767006
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
5626 Randolph Boulevard Suite 2
San Antonio, TX 78233
United States
County
Bexar
Phone
2102257400 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address