Contract Details
Ancillary Care Services
Facility name
Maximum Mobility
Provider ID
P000003887
NPI
1134225709
Tax ID
742650356
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
10709 Leopard Street
Corpus Christi, TX 78410
United States
County
Nueces
Phone
3612411800 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address