Richard  A  Vangergen    MD
Contract Details
Open MRI of Sylacauga
Facility name
Provider ID
P000001782
Tax ID
201652810
Effective Date
11/15/2004
Last Updated
8/29/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
315 West Hickory Street
Sylacauga, AL 35150
United States
County
Talladega
Phone
2562072686 (Phone)
Billing Details
Address
P.O. Box 933108
Atlanta, GA 31193
Billing Phone
2059959899
Specialty Type
Radiology, Diagnostic
Map
Address