Charlie    Ferguson    MD
Contract Details
Helen Keller Hospital
Facility name
Provider ID
P000000533
NPI
1962488429
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
2908 Mall Drive
Florence, AL 35630
United States
County
Lauderdale
Phone
2567672702 (Phone)
Billing Details
Address
P.O. Box 610
Sheffield, AL 35660
Billing Phone
2563864005
Specialty Type
Internal Medicine
Map
Address