Contract Details
Ancillary Care Services
Facility name
Multi-Medical Equipment & Supplies
Provider ID
P000004414
NPI
1396012886
Tax ID
453455868
Effective Date
4/1/2012
Last Updated
10/28/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
15229 Southwest Freeway
Sugar Land, TX 77478
United States
County
Fort Bend
Phone
2812653156 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address