Contract Details
Facility name
Outpatient Diagnostic Center of Birmingham
Provider ID
P000002312
NPI
1528016276
Tax ID
631059483
Effective Date
6/27/1996
Last Updated
4/16/2014
Direct Contract
Term Date
4/16/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_097
Location Details
Address
2173 Highland Avenue South
Birmingham, AL 35205
United States
County
Jefferson
Phone
2059338324 (Phone)
Billing Details
Address
P.O. Box 281206
Atlanta, GA 30384
Billing Phone
Specialty Type
Diagnostic Services
Map
Address