Terry    Kinnebrew    MD
Contract Details
BHC Gardendale
Facility name
Provider ID
P000000888
Tax ID
631120204
Effective Date
1/1/1996
Last Updated
2/4/2015
Direct Contract
Yes
Term Date
2/4/2015
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
758 South Main Street
Gardendale, AL 35071
United States
County
Jefferson
Phone
2056315521 (Phone)
Billing Details
Address
P.O. Box 830605
Birmingham, AL 35283
Billing Phone
2056315521
Specialty Type
Family Practice
Map
Address