Ostap    Woloschuk    MD
Contract Details
Russellville Hospital
Facility name
Provider ID
P000001898
NPI
1275641425
Tax ID
030464224
Effective Date
10/1/2003
Last Updated
7/16/2014
Direct Contract
Yes
Term Date
7/16/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_043
Location Details
Address
15155 Highway 43
Russellville, AL 35653
United States
County
Franklin
Phone
2563321611 (Phone)
Billing Details
Address
P.O. Box 1089
Russellville, AL 35653
Billing Phone
2563321611
Specialty Type
Legal Medicine
Map
Address