Contract Details
Facility name
Brookwood Primary Care - Red Mountain
Provider ID
P000002598
NPI
1205114840
Tax ID
630574010
Effective Date
4/24/2002
Last Updated
5/21/2017
Direct Contract
Yes
Term Date
3/17/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_058
Location Details
Address
1900 20th Street South Suite 102
Birmingham, AL 35209
United States
County
Jefferson
Phone
2059334520 (Phone)
Billing Details
Address
1900 20th Street South
Suite 102
Birmingham, AL 35209
Billing Phone
2059334520
Specialty Type
Family Practice
Map
Address