Contract Details
Ancillary Care Services
Facility name
Radiology Associates
Provider ID
P000004805
NPI
1558328963
Tax ID
591941740
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2115 Little Road
Trinity, FL 34655
United States
County
Pasco
Phone
7272471100 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address