Contract Details
Ancillary Care Services
Facility name
Twin Rivers Respiratory Care
Provider ID
P000003993
NPI
1194766030
Tax ID
161655984
Effective Date
4/1/2012
Last Updated
10/18/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2607 Caddo Street Suite 4
Arkadelphia, AR 71923
United States
County
Clark
Phone
3039058527 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address