Contract Details
One Call Care Management
Facility name
Heritage Diagnostic Center
Provider ID
P000002191
NPI
1295788222
Tax ID
223218521
Effective Date
6/1/1999
Last Updated
10/13/2015
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_059
Location Details
Address
1705 Main Avenue Southwest Suite C
Cullman, AL 35055
United States
County
Cullman
Phone
2567348175 (Phone)
Billing Details
Address
P.O. Box 614
Parsippany, NJ 07054
Billing Phone
8008722875
Specialty Type
Diagnostic Services
Map
Address