Contract Details
Ranbow Supply of New York Inc
Facility name
Rainbow Supply of New York
Provider ID
P000006256
Tax ID
841683075
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
9106 63rd Dr
Rego Park, NY 11374
United States
County
Queens
Phone
7183262822 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address