Contract Details
Ancillary Care Services
Facility name
Scenic City Medical Equipment
Provider ID
P000003807
NPI
1093820342
Tax ID
621862335
Effective Date
4/1/2012
Last Updated
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1941 Old York Highway
Dunlap, TN 37327
United States
County
Sequatchie
Phone
4239492200 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address