Contract Details
Fast360, LLC
Facility name
Baldwin Bone & Joint, PC
Provider ID
P000007576
NPI
1790714459
Tax ID
460926698
Effective Date
1/1/2017
Last Updated
12/13/2017
Direct Contract
No
Term Date
1/2/2017
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_312
Location Details
Address
1505 Daphne Avenue
Daphne, AL 36526
United States
County
Baldwin
Phone
8666746728 (Phone)
Billing Details
Address
761 Old Hickory Boulevard
Suite 300
Brentwood, TN 37027
Billing Phone
8666746728
Specialty Type
Diagnostic Services
Map
Address