Srihari Das    Kanuru    MD
Contract Details
Helen Keller Hospital
Facility name
Provider ID
P000000871
NPI
1306833744
Tax ID
630288825
Effective Date
7/15/2011
Last Updated
6/19/2014
Direct Contract
Yes
Term Date
1/13/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_023
Location Details
Address
234 Keller Park Boulevard
Tuscumbia, AL 35674
United States
County
Colbert
Phone
2563864300 (Phone)
Billing Details
Address
P.O. Box 610
Sheffield, AL 35660
Billing Phone
2563864005
Specialty Type
Pediatrics
Map
Address