Contract Details
Ancillary Care Services
Facility name
Rehabtech Supply
Provider ID
P000005411
NPI
1811163520
Tax ID
364141292
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
201 West Springfield Avenue Suite 704
Champaign, IL 61820
United States
County
Champaign
Phone
2173669287 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address