Contract Details
Facility name
Shades Mountain Imaging
Provider ID
P000002405
NPI
1033157185
Tax ID
201202415
Effective Date
3/1/2007
Last Updated
9/6/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
502 Montgomery Highway Suite 101
Birmingham, AL 35216
United States
County
Jefferson
Phone
2058230882 (Phone)
Billing Details
Address
502 Montgomery Highway
Suite 101
Birmingham, AL 35216
Billing Phone
2058230882
Specialty Type
Diagnostic Services
Map
Address