Contract Details
Ancillary Care Services
Facility name
Royston Diagnostic Center
Provider ID
P000004009
NPI
1205886348
Tax ID
201003401
Effective Date
4/1/2012
Last Updated
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
930 Franklin Springs Street
Royston, GA 30662
United States
County
Franklin
Phone
7062469729 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address