Contract Details
Ancillary Care Services
Facility name
Scott Medical Imaging
Provider ID
P000006150
Tax ID
640868263
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
1883 Highway 43
Canton, MS 39046
United States
County
Madison
Phone
6014071106 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address