Contract Details
Bridgeway Diagnostic Radiology
Facility name
Bridgeway Diagnostic Radiology
Provider ID
P000008280
NPI
1306248729
Tax ID
471579306
Effective Date
5/19/2019
Last Updated
11/14/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
100 Bascom Ct
Columbus, GA 31909
United States
County
Muscogee
Phone
7063505800 (Phone)
Billing Details
Address
100 Bascom Ct
Columbus, GA 31909
Billing Phone
7063505800
Specialty Type
Diagnostic Services
Map
Address