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Contract Details
American Health Imaging of Alabama, LLC
Facility name
American Health Imaging of Birmingham, LLC
Provider ID
P000001996
NPI
1730164765
Tax ID
631226975
Effective Date
8/17/2017
Last Updated
8/23/2017
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_342
AM_342
Location Details
Address
2101 4th Avenue South Suite 100
Birmingham, AL 35233
United States
County
Jefferson
Phone
2052511300
(
Phone
)
Billing Details
Address
2101 4th Avenue South
Suite 100
Birmingham, AL 35233
Billing Phone
2052511300
Specialty Type
Diagnostic Services
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Address