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Ha
B
Chu
MD
Contract Details
Bailey Cove Family Practice
Facility name
Provider ID
P000008443
NPI
1346496999
Tax ID
273920921
Effective Date
5/18/2016
Last Updated
5/25/2016
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
10300 Bailey Cove Road Suite 13
Huntsville, AL 35803
United States
County
Madison
Phone
2564295248
(
Phone
)
Billing Details
Address
P.O. Box 689022
Franklin, TN 37068
Billing Phone
6154657000
Specialty Type
Family Practice
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Address