Contract Details
Ancillary Care Services
Facility name
Wecare Medical
Provider ID
P000005273
NPI
1750615621
Tax ID
270990360
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
310 Langdon Street Suite 1
Somerset, KY 42503
United States
County
Pulaski
Phone
6066779472 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address