Contract Details
Ancillary Care Services
Facility name
Premier Medical Imaging
Provider ID
P000003910
NPI
1144378993
Tax ID
261289233
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
601 North Congress Avenue Suite 311
Delray Beach, FL 33445
United States
County
Palm Beach
Phone
5619210922 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address