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
700 Tilghman Drive Suite 702
Dunn, NC 28334
United States
County
Harnett
Phone
9108921068 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address