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Contract Details
The Radiology Clinic
Facility name
The Radiology Clinic
Provider ID
P000002462
NPI
1649235243
Tax ID
630313602
Effective Date
7/27/2018
Last Updated
7/30/2018
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_391
AM_391
Location Details
Address
208 McFarland Circle North Suite 100
Tuscaloosa, AL 35406
United States
County
Tuscaloosa
Phone
2053457000
(
Phone
)
Billing Details
Address
208 McFarland Circle North
Suite 100
Tuscaloosa, AL 35406
Billing Phone
2053457000
Specialty Type
Magnetic Resonance Imaging (MRI) Facility
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Address