Contract Details
Ancillary Care Services
Facility name
Oxygen Plus
Provider ID
P000005571
NPI
1891983672
Tax ID
061669749
Effective Date
4/1/2012
Last Updated
9/26/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
307 Betsy Pack Drive
Jasper, TN 37347
United States
County
Marion
Phone
4239420711 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address