Contract Details
Ancillary Care Services
Facility name
Genetics of Memphis
Provider ID
P000003905
NPI
1144308479
Tax ID
470888083
Effective Date
4/1/2012
Last Updated
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
1770 Moriah Woods Boulevard Suite 3
Memphis, TN 38117
United States
County
Shelby
Phone
9016850333 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address