Contract Details
Ancillary Care Services
Facility name
Select Diagnostics
Provider ID
P000004379
NPI
1376642827
Tax ID
562017400
Effective Date
4/1/2012
Last Updated
10/16/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
2961 Crouse Lane Suite C
Burlington, NC 27215
United States
County
Alamance
Phone
3365869799 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address