Lindsay    Harrison    NP
Contract Details
Good Hope Medical Inc.
Facility name
Provider ID
P000000001
NPI
1447697016
Tax ID
863446339
Effective Date
3/15/2022
Last Updated
3/21/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1225 County Road
Cullman, AL 35055
United States
Phone
256-615-2055 (Phone)
Billing Details
Address
P.O. Box 920109
Dallas, TX 75392
Billing Phone
815-544-7480
Specialty Type
Nurse Practitioner
Workers Comp Coordinator
Sonya
Fortner
256-615-2055
sonya@goodhopemedical.com
Map
Address