Contract Details
Ancillary Care Services
Facility name
Citrus Open MRI Center
Provider ID
P000005560
NPI
1891789673
Tax ID
593037078
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
2687 East Gulf To Lake Highway
Inverness, FL 34453
United States
County
Citrus
Phone
3526374466 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address