Contract Details
Ancillary Care Services
Facility name
Wecare Medical
Provider ID
P000003767
NPI
1073829412
Tax ID
753165381
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
105 Hills Plaza Patrick Street
Charleston, WV 25387
United States
County
Kanawha
Phone
3042055212 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address