Contract Details
Ancillary Care Services
Facility name
Gamma Healthcare Gastroenterology
Provider ID
P000005832
Tax ID
431922303
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
88.00
Location Details
Address
409 North University Avenue
Little Rock, AR 72205
United States
County
Pulaski
Phone
5016646980 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address