Contract Details
Ancillary Care Services
Facility name
Oracle Diagnostic Laboratory
Provider ID
P000005197
NPI
1720090194
Tax ID
562017400
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
8100 Royal Palms Boulevard Suite 103
Coral Springs, FL 33065
United States
County
Broward
Phone
9542410710 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address