Contract Details
Ancillary Care Services
Facility name
InMed Diagnostic Services of South Carolina
Provider ID
P000006415
Tax ID
571072663
Effective Date
4/1/2012
Last Updated
10/17/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
126 South Assembly Street
Columbia, SC 29201
United States
County
Richland
Phone
8039880082 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address