Contract Details
Ancillary Care Services
Facility name
Medical Necessities & Services
Provider ID
P000004513
NPI
1427132125
Tax ID
830339506
Effective Date
4/1/2012
Last Updated
9/26/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
1811 Charlotte Avenue
Nashville, TN 37203
United States
County
Davidson
Phone
6155153669 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address