Contract Details
AmeriPath
Facility name
Coliseum Medical Centers
Provider ID
P000006712
NPI
1467502716
Tax ID
581267100
Effective Date
5/16/2012
Last Updated
9/25/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
350 Hospital Drive
Macon, GA 312173838
United States
County
Bibb
Phone
4787430212 (Phone)
Billing Details
Address
PO Box 100191
Atlanta, GA 303840191
Billing Phone
4075874457
Specialty Type
Laboratory Service Provider
Map
Address