Contract Details
Ancillary Care Services
Facility name
Excel Medical Imaging
Provider ID
P000005157
NPI
1700884244
Tax ID
593743793
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
5626 Gulf Drive
New Port Richey, FL 34652
United States
County
Pasco
Phone
7278418212 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address