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Contract Details
Ancillary Care Services
Facility name
MedEquip
Provider ID
P000006458
Tax ID
330592703
Effective Date
4/1/2012
Last Updated
10/11/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
6802 Paragon Place Suite 409
Richmond, VA 23230
United States
County
Henrico
Phone
8009443422
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address