Contract Details
Ancillary Care Services
Facility name
The Scooter Store USA
Provider ID
P000004581
NPI
1457386047
Tax ID
743009889
Effective Date
4/1/2012
Last Updated
10/9/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
6530 East Rogers Circle
Boca Raton, FL 33487
United States
County
Palm Beach
Phone
8007715449 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address