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
Term Date
9/16/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
110 Lafayette Street
Livingston, AL 35470
United States
County
Sumter
Phone
6014824003 (Phone)
Billing Details
Address
1170 Northeast Industrial Park Road
Meridian, MS 39301
Billing Phone
6014827420
Specialty Type
Home Infusion
Map
Address