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Contract Details
Encore Rehabilitation, Inc.
Facility name
Encore Rehab of Moulton
Provider ID
P000002127
NPI
1700912052
Tax ID
631225408
Effective Date
8/10/2000
Last Updated
9/12/2019
Direct Contract
Yes
Term Date
8/31/2019
Status
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
11186 Highway 157 Suite B
Moulton, AL 35650
United States
County
Lawrence
Phone
2569057295
(
Phone
)
Billing Details
Address
1908 Flint Road Southeast
Decatur, AL 35601
Billing Phone
2563409708
Specialty Type
Physical Therapy
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