Contract Details
Open MRI on 280, LLC
Facility name
ImageSouth 280
Provider ID
P000002296
NPI
1801867890
Tax ID
753071677
Effective Date
11/1/2004
Last Updated
4/26/2017
Direct Contract
Yes
Term Date
4/19/2017
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2737 Highway 280 Suite 141
Birmingham, AL 35223
United States
County
Jefferson
Phone
2058701979 (Phone)
Billing Details
Address
P.O. Box 932602
Atlanta, GA 31193
Billing Phone
2059959899
Specialty Type
Magnetic Resonance Imaging (MRI) Facility
Map
Address