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Contract Details
Ancillary Care Services
Facility name
A1 Imaging Centers
Provider ID
P000005246
NPI
1740440890
Tax ID
262562595
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Term Date
9/30/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
1975 Veterans Parkway
Columbus, GA 31904
United States
County
Muscogee
Phone
7066538303
(
Phone
)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address