Contract Details
Ancillary Care Services
Facility name
Rose Radiology Centers
Provider ID
P000004969
NPI
1629162904
Tax ID
593698438
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
10910 State Road 70 Suite 103
Bradenton, FL 34202
United States
County
Manatee
Phone
9417555257 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address