Contract Details
Fast360, LLC
Facility name
ImageSouth Shelby
Provider ID
P000002210
NPI
1649241639
Tax ID
460926698
Effective Date
1/1/2017
Last Updated
5/21/2017
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_312
Location Details
Address
224 1st Street North Suite 150
Alabaster, AL 35007
United States
County
Shelby
Phone
8666746728 (Phone)
Billing Details
Address
761 Old Hickory Boulevard
Suite 300
Brentwood, TN 37027
Billing Phone
8666746728
Specialty Type
Diagnostic Services
Map
Address