Contract Details
One Call Care Management
Facility name
High Tech Imaging Center
Provider ID
P000002192
NPI
1588753297
Tax ID
223218521
Effective Date
6/1/1999
Last Updated
10/13/2015
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_059
Location Details
Address
1510 Forest Avenue
Montgomery, AL 36106
United States
County
Montgomery
Phone
3342567213 (Phone)
Billing Details
Address
P.O. Box 614
Parsippany, NJ 07054
Billing Phone
8008722875
Specialty Type
Diagnostic Services
Map
Address