Contract Details
Ancillary Care Services
Facility name
Soteria Imaging Services
Provider ID
P000004353
NPI
1366469181
Tax ID
351879795
Effective Date
4/1/2012
Last Updated
10/10/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
9200 Leegate Road Suite 100
Louisville, KY 40222
United States
County
Jefferson
Phone
5024771815 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address