Contract Details
Southern Physical Rehab Network
Facility name
TherapySouth Pelham
Provider ID
P000002469
NPI
1730286964
Tax ID
205548746
Effective Date
12/5/2006
Last Updated
10/1/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3569 Pelham Parkway Suite 7
Pelham, AL 35124
United States
County
Shelby
Phone
2056648404 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address