Contract Details
Facility name
J & S Medical Supply
Provider ID
P000004663
NPI
1487793824
Tax ID
820567787
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
4306 3rd Ave
Brooklyn, NY 11232
United States
County
Kings
Phone
7184995284 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address