Contract Details
Facility name
Millennium Health, LLC
Provider ID
P000002259
NPI
1497933162
Tax ID
261565558
Effective Date
12/1/2010
Last Updated
10/16/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
105.00
Fee Schedule Multiplier
Location Details
Address
16981 Via Tazon Suite F
San Diego, CA 921271645
United States
County
San Diego
Phone
8774513534 (Phone)
Billing Details
Address
P.O. Box 841773
Dallas, TX 75284
Billing Phone
8584513535
Specialty Type
Laboratory Service Provider
Map
Address