Contract Details
Ancillary Care Services
Facility name
Bostwick Laboratories
Provider ID
P000004442
NPI
1396929378
Tax ID
050593169
Effective Date
4/1/2012
Last Updated
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
320 Plus Park Boulevard
Nashville, TN 37217
United States
County
Davidson
Phone
6158152860 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address