Contract Details
Pomac Prosthetic & Orthotic Management
Facility name
Sampson's Prosthetic & Orthotic Laboratory
Provider ID
P000006400
Tax ID
113154194
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
400 Patroon Creek Blvd Suite 106
Albany, NY 12206
United States
County
Albany
Phone
5183746011 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Orthotics/Prosthetics, Services
Map
Address