Contract Details
Ancillary Care Services
Facility name
Lifeway Medical Equipment
Provider ID
P000006525
Tax ID
364598635
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
6529 West Plano Parkway Suite D
Plano, TX 75093
United States
County
Collin
Phone
9727140014 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address