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
4551 4th Street North
Saint Petersburg, FL 33703
United States
County
Pinellas
Phone
7275253800 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address