Contract Details
Ancillary Care Services
Facility name
InMed Diagnostic Services of South Carolina
Provider ID
P000006416
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
1704 East Main Street
Duncan, SC 29334
United States
County
Spartanburg
Phone
8644868595 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address