Contract Details
Ancillary Care Services
Facility name
Radiological Institute of Ocala
Provider ID
P000003673
NPI
1023373404
Tax ID
861093368
Effective Date
4/1/2012
Last Updated
5/21/2017
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
419 Southwest 15th Street Suite 200
Ocala, FL 34471
United States
County
Marion
Phone
3526223002 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address