Contract Details
Facility name
Deep South Home Medical Equipment
Provider ID
P000002082
NPI
1871569129
Tax ID
450495549
Effective Date
9/15/2003
Last Updated
9/3/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
229 Sunrise Lane
Malvern, AL 36349
United States
County
Geneva
Phone
3346719484 (Phone)
Billing Details
Address
P.O. Box 83
Malvern, AL 36349
Billing Phone
3346719484
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address