Contract Details
Ancillary Care Services
Facility name
MediForce
Provider ID
P000004469
NPI
1417007097
Tax ID
134314145
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1702 East Tyler Avenue Suite 5
Harlingen, TX 78550
United States
County
Cameron
Phone
9564236333 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address