Contract Details
Ancillary Care Services
Facility name
Wecare Medical
Provider ID
P000004484
NPI
1417263864
Tax ID
753165381
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
627 Maysville Road Suite A
Mount Sterling, KY 40353
United States
County
Montgomery
Phone
8594994220 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address