Ron    Pitkanen   
Contract Details
Comprehensive Pain Center
Facility name
Provider ID
842840585
NPI
1457677015
Tax ID
842840585
Effective Date
1/14/2020
Last Updated
1/23/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
2700 Highway 280
Birmingham, AL 35242
United States
Phone
2058784368 (Phone)
Billing Details
Address
2700 Highway 280
Birmingham, AL 35242
Billing Phone
2058784368
Specialty Type
Pain Management Facility