Contract Details
Southern Radiology Specialists
Facility name
Blue Water Radiology
Provider ID
P000000001
Tax ID
472155388
Effective Date
1/10/2024
Last Updated
1/18/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
4536 E Hwy 20
Niceville, FL 32578
United States
Phone
850-729-6747 (Phone)
Billing Details
Address
4536 E Hwy 20
Niceville, FL 32578
Billing Phone
850-729-6747
Specialty Type
Diagnostic Services
Website
Visit Website
Map
Address