Contract Details
Ancillary Care Services
Facility name
A1 Imaging of Mandarin
Provider ID
P000005271
NPI
1750549804
Tax ID
262562595
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
3753 Cardinal Point Drive
Jacksonville, FL 32223
United States
County
Duval
Phone
9046365674 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address