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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
Yes
Term Date
4/16/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_097
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
2059338324
Specialty Type
Diagnostic Services
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Address