Contract Details
Southern Physical Rehab Network
Facility name
Alabama Physical Rehabilitation Services
Provider ID
P000007126
NPI
1619935533
Tax ID
630797708
Effective Date
8/28/1995
Last Updated
7/3/2019
Direct Contract
Yes
Term Date
11/17/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1475 1st Avenue Southwest
Jacksonville, AL 36265
United States
County
Calhoun
Phone
2564359386 (Phone)
Billing Details
Address
109 9th Street Southwest
Suite C
Cullman, AL 35055
Billing Phone
2567369926
Specialty Type
Physical Therapy
Map
Address