Contract Details
One Call Care Management
Facility name
Shades Mountain Imaging
Provider ID
P000002405
NPI
1033157185
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
502 Montgomery Highway Suite 101
Birmingham, AL 35216
United States
County
Jefferson
Phone
2058230882 (Phone)
Billing Details
Address
P.O. Box 614
Parsippany, NJ 07054
Billing Phone
8008722875
Specialty Type
Diagnostic Services
Map
Address