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Contract Details
Facility name
Gerhardt & Brackin
Provider ID
P000002164
NPI
1922104389
Tax ID
562349357
Effective Date
2/1/2004
Last Updated
6/6/2014
Direct Contract
Yes
Term Date
5/14/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1004 1st Street North Suite 350
Alabaster, AL 35007
United States
County
Shelby
Phone
2056632103
(
Phone
)
Billing Details
Address
1004 1st Street North
Suite 350
Alabaster, AL 35007
Billing Phone
2056632103
Specialty Type
Surgery, Orthopedic
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Address