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Contract Details
Vital Care Home Infusion Services
Facility name
Vital Care of Meridian
Provider ID
P000002501
NPI
1780619528
Tax ID
631052460
Effective Date
8/25/2011
Last Updated
6/9/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1501 23rd Avenue
Meridian, MS 39301
United States
County
Lauderdale
Phone
6014824003
(
Phone
)
Billing Details
Address
1170 Northeast Industrial Park Road
Meridian, MS 39301
Billing Phone
6014827420
Specialty Type
Home Infusion
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