Contract Details
Mobility Medical Equipment, Inc
Facility name
Mobility Medical Equipment, Inc Tyler
Provider ID
P000005174
NPI
1710210877
Tax ID
752830528
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
120 West Goodman St
Tyler, TX 75702
United States
County
Smith
Phone
9035339090 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address