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Contract Details
Facility name
Alabama Bone & Joint Clinic
Provider ID
P000001948
NPI
1780980540
Tax ID
274655689
Effective Date
3/1/1994
Last Updated
8/19/2014
Direct Contract
Yes
Term Date
3/13/2013
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
720 Montclair Road Suite 200
Birmingham, AL 35213
United States
County
Jefferson
Phone
2055912516
(
Phone
)
Billing Details
Address
120 Cahaba Valley Parkway
Suite 100
Pelham, AL 35124
Billing Phone
2056213778
Specialty Type
Surgery, Orthopedic
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Address