Contract Details
Ancillary Care Services
Facility name
Reuss Pharmacy
Provider ID
P000004380
NPI
1376659557
Tax ID
742586210
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
72.00
Location Details
Address
515 North Esplanade Street
Cuero, TX 77954
United States
County
De Witt
Phone
3612753411 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address