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Contract Details
Facility name
Corporate Pharmacy Services
Provider ID
P000002065
NPI
1437194933
Tax ID
631040950
Effective Date
8/1/1994
Last Updated
9/3/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_082
AM_082
Location Details
Address
319 Broad Street
Gadsden, AL 35902
United States
County
Etowah
Phone
2565439000
(
Phone
)
Billing Details
Address
P.O. Box 1950
Gadsden, AL 35902
Billing Phone
2565439000
Specialty Type
Pharmacy
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Address