Samantha    Baggett    CRNP
Contract Details
Roanoke Urgent Care
Facility name
Provider ID
P000008560
NPI
1548673403
Tax ID
630819576
Effective Date
1/19/2017
Last Updated
1/23/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1950 Main Street
Roanoke, AL 36274
United States
County
Randolph
Phone
3348632311 (Phone)
Billing Details
Address
1950 Main Street
Roanoke, AL 36274
Billing Phone
3348632311
Specialty Type
Family Practice
Map
Address