Contract Details
Ancillary Care Services
Facility name
Integrity Medical
Provider ID
P000005404
NPI
1801979596
Tax ID
061659963
Effective Date
4/1/2012
Last Updated
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1001 Walton Way
Augusta, GA 30901
United States
County
Richmond
Phone
7068558988 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address