Contract Details
Ancillary Care Services
Facility name
Open MRI of Sanford
Provider ID
P000003929
NPI
1164409413
Tax ID
593456023
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
303 West 1st Street
Sanford, FL 32771
United States
County
Seminole
Phone
4073307333 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address