Ryan  A  Gregorio    MD
Contract Details
American Family Care--Hampton Cove
Facility name
Provider ID
P000000651
NPI
1285849729
Tax ID
630825248
Effective Date
7/1/2011
Last Updated
4/24/2018
Direct Contract
Yes
Term Date
4/24/2018
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
410 Sutton Road Southeast
Owens Cross Roads, AL 35763
United States
County
Madison
Phone
2564244260 (Phone)
Billing Details
Address
P.O. Box 830810
Birmingham, AL 35283
Billing Phone
2054038902
Specialty Type
Family Practice
Map
Address