Contract Details
Ancillary Care Services
Facility name
A1 Imaging of Augusta
Provider ID
P000005410
NPI
1811157977
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
2803 Wrightsboro Road Suite 18
Augusta, GA 30909
United States
County
Richmond
Phone
7067299800 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address