Contract Details
Facility name
Montgomery Open MRI
Provider ID
P000002270
NPI
1699733394
Tax ID
631283359
Effective Date
1/16/2002
Last Updated
9/3/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
249 Winton M. Blount Loop
Montgomery, AL 36117
United States
County
Montgomery
Phone
3342130036 (Phone)
Billing Details
Address
P.O. Box 933550
Atlanta, GA 31193
Billing Phone
3342130036
Specialty Type
Diagnostic Services
Map
Address