Ashley    Godfrey    NP
Contract Details
Cullman Regional Family Care
Facility name
Provider ID
P000000001
NPI
1316485865
Tax ID
462447900
Effective Date
12/17/2020
Last Updated
1/11/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1912 AL Highway 157
Cullman, AL 35058
United States
Phone
2567372000 (Phone)
Billing Details
Address
1912 AL Highway 157
Cullman, AL 35058
Billing Phone
2567372000
Specialty Type
Occupational Medicine
Website
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