Contract Details
Ancillary Care Services
Facility name
Ritecare Medical Supply
Provider ID
P000005485
NPI
1861426801
Tax ID
562486866
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
717 South Greenville Avenue Suite 102
Allen, TX 75002
United States
County
Collin
Phone
9723960871 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address