Contract Details
Facility name
Fourroux Prosthetics
Provider ID
P000002147
NPI
1528089604
Tax ID
630480130
Effective Date
10/3/2007
Last Updated
9/22/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
2743 Bob Wallace Avenue Southwest
Huntsville, AL 35805
United States
County
Madison
Phone
2565348672 (Phone)
Billing Details
Address
2743 Bob Wallace Avenue Southwest
Huntsville, AL 35805
Billing Phone
2565348672
Specialty Type
Orthotics/Prosthetics, Services
Map
Address