Contract Details
Facility name
Birmingham Evaluation Services Technology
Provider ID
P000007170
NPI
1245558261
Tax ID
432117399
Effective Date
12/1/2009
Last Updated
1/15/2014
Direct Contract
Yes
Term Date
1/5/2012
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
880 Montclair Road Suite 571
Birmingham, AL 35213
United States
County
Jefferson
Phone
2055917929 (Phone)
Billing Details
Address
880 Montclair Road
Suite 571
Birmingham, AL 35213
Billing Phone
2055917929
Specialty Type
General Practice
Map
Address