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Contract Details
Facility name
ABC Orthotics and Prosthetics
Provider ID
P000001933
NPI
1356347926
Tax ID
630637809
Effective Date
3/15/2006
Last Updated
3/4/2022
Direct Contract
Yes
Term Date
2/28/2022
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3616 7th Court South
Birmingham, AL 35222
United States
County
Jefferson
Phone
2053242461
(
Phone
)
Billing Details
Address
3616 7th Court South
Birmingham, AL 35222
Billing Phone
2053242461
Specialty Type
Orthotics/Prosthetics, Services
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