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Contract Details
Facility name
Outpatient Diagnostic Center of Huntsville
Provider ID
P000002313
NPI
1811945306
Tax ID
631059483
Effective Date
12/1/1997
Last Updated
5/21/2017
Direct Contract
Yes
Term Date
2/18/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_097
AM_097
Location Details
Address
115 Saint Clair Avenue Southeast
Huntsville, AL 35801
United States
County
Madison
Phone
2565345600
(
Phone
)
Billing Details
Address
Healthsouth Diagnostics
PO Box 281206
Atlanta, GA 303841206
Specialty Type
Diagnostic Services
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Address