Contract Details
Ancillary Care Services
Facility name
Pasco Imaging & Open MRI
Provider ID
P000005647
NPI
1932193711
Tax ID
593037178
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
7615 Jacque Road
Hudson, FL 34667
United States
County
Pasco
Phone
7276970100 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address