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Contract Details
University of Alabama Health Services Foundation, P.C.
Facility name
UAB Health Services Foundation
Provider ID
P000002482
Tax ID
630649108
Effective Date
6/21/1995
Last Updated
3/26/2014
Direct Contract
Yes
Term Date
3/21/2014
Status
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
500 22nd Street South
Birmingham, AL 35233
United States
County
Jefferson
Phone
2057319600
(
Phone
)
Billing Details
Address
P.O. Box 55309
Birmingham, AL 35255
Billing Phone
2059349999
Specialty Type
General Practice
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Address