Will    Thames    OTR
Contract Details
Rehab Associates--Montgomery-Jackson Hospital
Facility name
Provider ID
P000001726
NPI
1134165400
Tax ID
721379381
Effective Date
8/28/1995
Last Updated
6/4/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1801 Pine Street Suite 102
Montgomery, AL 36106
United States
County
Montgomery
Phone
3342626161 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
Specialty Type
Occupational Therapy
Map
Address