Contract Details
Facility name
AmeriPath
Provider ID
P000006716
NPI
1619940517
Tax ID
650641688
Effective Date
5/16/2012
Last Updated
9/25/2013
Direct Contract
Yes
Term Date
4/12/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
8100 Chancellor Drive Suite 130
Orlando, FL 328097284
United States
County
Orange
Phone
8003957284 (Phone)
Billing Details
Address
16684 Collections Center Drive
Chicago, IL 606930166
Billing Phone
8668367136
Specialty Type
Laboratory Service Provider
Map
Address