Contract Details
Ancillary Care Services
Facility name
Sunbelt Medical Supply & Oxygen
Provider ID
P000004898
NPI
1598753527
Tax ID
651115789
Effective Date
4/1/2012
Last Updated
10/9/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
4502 35th Street Suite 100
Orlando, FL 32811
United States
County
Orange
Phone
4073160010 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address