Contract Details
Facility name
Woodland Occupational Health Clinic
Provider ID
P000001960
NPI
1154362655
Tax ID
631189798
Effective Date
12/1/2001
Last Updated
9/16/2013
Direct Contract
Yes
Term Date
9/16/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1908 Cherokee Avenue Southwest
Cullman, AL 35055
United States
County
Cullman
Phone
2567379416 (Phone)
Billing Details
Address
Specialty Type
Occupational Medicine Facility
Map
Address