Contract Details
Ancillary Care Services
Facility name
Oxygen Rich
Provider ID
P000005567
NPI
1891867354
Tax ID
205504609
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
805 Kings Way
Wake Village, TX 75501
United States
County
Bowie
Phone
9038317424 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address