Contract Details
Ancillary Care Services
Facility name
Beaches Open MRI
Provider ID
P000003736
NPI
1063564672
Tax ID
650939085
Effective Date
4/1/2012
Last Updated
10/9/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
350 10th Avenue South
Jacksonville Beach, FL 32250
United States
County
Duval
Phone
9042472220 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address