Contract Details
Triad of Alabama, LLC
Facility name
Breathing Care Associates
Provider ID
P000002023
NPI
1538111646
Tax ID
621762412
Effective Date
3/1/2005
Last Updated
6/13/2014
Direct Contract
Yes
Term Date
4/30/2012
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
119 South Woodburn Drive Suite 1
Dothan, AL 36305
United States
County
Houston
Phone
3347939674 (Phone)
Billing Details
Address
P.O. Box 6907
Dothan, AL 36302
Billing Phone
3347939674
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address