Contract Details
Ancillary Care Services
Facility name
Monarch Medical & Rehab Supply
Provider ID
P000005576
NPI
1902118730
Tax ID
272671832
Effective Date
5/24/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1961 South Main Street Suite 300
Keller, TX 76248
United States
County
Tarrant
Phone
8888303018 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address