Contract Details
Ancillary Care Services
Facility name
SelectCare
Provider ID
P000006417
Tax ID
522051460
Effective Date
4/1/2012
Last Updated
10/17/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3650 Centre Circle Drive Suite H
Fort Mill, SC 29715
United States
County
York
Phone
8035481446 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address