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
Yes
Term Date
1/4/2013
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_080
Location Details
Address
7088 University Court
Montgomery, AL 361176992
United States
County
Montgomery
Phone
3342739660 (Phone)
Billing Details
Address
Specialty Type
Orthotics/Prosthetics, Services
Map
Address