Contract Details
Ancillary Care Services
Facility name
The Imaging Center of West Palm Beach
Provider ID
P000004750
NPI
1538152939
Tax ID
421581519
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
2450 Metrocentre Boulevard
West Palm Beach, FL 33407
United States
County
Palm Beach
Phone
5616849020 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address