Contract Details
Ancillary Care Services
Facility name
Northwest Georgia Home Health & Oxygen
Provider ID
P000005936
Tax ID
581440533
Effective Date
4/1/2012
Last Updated
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
412 North Park Drive
Dalton, GA 30720
United States
County
Whitfield
Phone
7062260520 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address