Contract Details
Soteria Imaging Services
Facility name
Jamestown Open MRI (T)
Provider ID
P000004376
NPI
1376546390
Tax ID
010721437
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
15 South Main St Suite 250
Jamestown, NY 14701
United States
County
Chautauqua
Phone
7166651198 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address