Contract Details
Facility name
Injury Supply Specialists
Provider ID
P000002214
Tax ID
721382528
Effective Date
5/15/1999
Last Updated
5/30/2013
Direct Contract
Term Date
1/4/2013
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
7088 University Court
Montgomery, AL 36117
United States
County
Montgomery
Phone
3342739660 (Phone)
Billing Details
Address
PO Box 240698
Attn: Brian
Montgomery, AL 36124
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address