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Contract Details
Ancillary Care Services
Facility name
Sapenoff & Harris
Provider ID
P000005190
NPI
1710996905
Tax ID
591718851
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
4678 Okeechobee Boulevard
West Palm Beach, FL 33417
United States
County
Palm Beach
Phone
5616891414
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
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Address