Contract Details
Facility name
Lowery Medical Supply Inc
Provider ID
P000005066
NPI
1679553267
Tax ID
752863160
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
30 TX Hwy 24
Cooper, TX 75432
United States
County
Delta
Phone
9033954508 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address