Contract Details
Ancillary Care Services
Facility name
Signet Diagnostic Imaging Tampa
Provider ID
P000005910
Tax ID
223826279
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Term Date
9/30/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
4325 Henderson Boulevard
Tampa, FL 33629
United States
County
Hillsborough
Phone
8136391674 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address