Contract Details
Ancillary Care Services
Facility name
Open MRI
Provider ID
P000005301
NPI
1770550550
Tax ID
611297160
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
5227 Dixie Highway
Louisville, KY 40216
United States
County
Jefferson
Phone
5024296500 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address