Contract Details
Ancillary Care Services
Facility name
Mid Cities Home Medical Equipment
Provider ID
P000005133
NPI
1699831131
Tax ID
752457458
Effective Date
4/1/2012
Last Updated
11/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2112 Rutland Drive Suite 176
Austin, TX 78758
United States
County
Travis
Phone
9726417445 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address