Contract Details
Integra Health LLC
Facility name
Integra Health LLC
Provider ID
P000005714
NPI
1962502229
Tax ID
421685996
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
410 Lakeville Rd
New Hyde Park, NY 11042
United States
County
Nassau
Phone
5164379000 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address