Contract Details
Facility name
Carmichael Imaging
Provider ID
P000002033
NPI
1497707111
Tax ID
010639582
Effective Date
12/15/2009
Last Updated
8/26/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
4145 Carmichael Road
Montgomery, AL 36106
United States
County
Montgomery
Phone
3343871100 (Phone)
Billing Details
Address
2257 Taylor Road
Suite 200
Montgomery, AL 36117
Billing Phone
3343871100
Specialty Type
Diagnostic Services
Map
Address