Ancillary Provider Agreement Sample Contracts

RECITALS
Ancillary Provider Agreement • April 23rd, 1998 • Certified Diabetic Services Inc • Services-misc health & allied services, nec • New York
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BLUE CROSS AND BLUE SHIELD OF TEXAS ANCILLARY PROVIDER AGREEMENT FOR PPO/POS NETWORK PARTICIPATION
Ancillary Provider Agreement • July 27th, 2009 • Certified Diabetic Services Inc • Services-misc health & allied services, nec • Texas

This Agreement is entered into by and between Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association (“BCBSTX”), and Certified Diabetic Supplies, Inc., on behalf of each of the individual Ancillary Providers and Provider numbers listed herein in Exhibit C (“Ancillary Provider”).

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