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Larue
W
Harding
DDS
Contract Details
Helen Keller Hospital
Facility name
Provider ID
P000000711
NPI
1770690059
Tax ID
630288825
Effective Date
7/15/2011
Last Updated
6/19/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_023
AM_023
Location Details
Address
1300 South Montgomery Avenue
Sheffield, AL 35660
United States
County
Colbert
Phone
2563864073
(
Phone
)
Billing Details
Address
P.O. Box 610
Sheffield, AL 35660
Billing Phone
2563864005
Specialty Type
Dentistry
Map
Address