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Contract Details
Ancillary Care Services
Facility name
Summit HME
Provider ID
P000005683
NPI
1952301608
Tax ID
742827836
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
1070 Arion Circle Suite 164
San Antonio, TX 78216
United States
County
Bexar
Phone
2105219800
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address