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Contract Details
Facility name
Aegis Sciences Corporation
Provider ID
P000001944
NPI
1699782722
Tax ID
880241758
Effective Date
9/8/2009
Last Updated
3/27/2013
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
515 Great Circle Road
Nashville, TN 372281310
United States
County
Davidson
Phone
6152552400
(
Phone
)
Billing Details
Address
PO Box 306061
Nashville, TN 372306061
Specialty Type
Laboratory Service Provider
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Address