Contract Details
Ancillary Care Services
Facility name
I&E Respiratory Care Service
Provider ID
P000004237
NPI
1306807342
Tax ID
640914837
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
8880 Louisiana Street
Merrillville, IN 46410
United States
County
Lake
Phone
2197564227 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address