Contract Details
Ancillary Care Services
Facility name
Sleep Management Centers
Provider ID
P000004590
NPI
1457458077
Tax ID
201871142
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
6350 Techster Boulevard Suite 2
Fort Myers, FL 33966
United States
County
Lee
Phone
2393348144 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
Map
Address