Contract Details
Ancillary Care Services
Facility name
IMS Experts
Provider ID
P000005750
NPI
1972697068
Tax ID
680574833
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
120 North Main Street
Mansfield, TX 76063
United States
County
Tarrant
Phone
8174539767 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address