Contract Details
Pomac Prosthetic & Orthotic Management
Facility name
Orthotics & Prosthetics Technologies Corp
Provider ID
P000005820
NPI
1699865147
Tax ID
113154194
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
2 Aura Dr
Valley Cottage, NY 10989
United States
County
Rockland
Phone
8453584747 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address