Contract Details
Ancillary Care Services
Facility name
Partners Imaging Center of Venice
Provider ID
P000004724
NPI
1518280635
Tax ID
204363724
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
842 Sunset Lake Boulevard Suite 301
Venice, FL 34292
United States
County
Sarasota
Phone
9414410060 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address