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Contract Details
TherapySouth--Talladega
Facility name
Provider ID
P000007528
NPI
1508165218
Tax ID
208098768
Effective Date
2/15/2012
Last Updated
11/29/2018
Direct Contract
Yes
Term Date
11/28/2018
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
727 Stone Avenue
Talladega, AL 35160
United States
County
Talladega
Phone
2563159693 (Phone)
Billing Details
Address
2823 Greystone Commercial Boulevard
Birmingham, AL 35242
Billing Phone
2054081713
Specialty Type
Physical Therapy
Map
Address