Contract Details
Rehab Associates
Facility name
Champion Sports Medicine
Provider ID
P000009212
NPI
1396222162
Tax ID
721379381
Effective Date
8/6/2018
Last Updated
2/8/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
200 Montgomery Highway Suite 150
Birmingham, AL 35216
United States
County
Jefferson
Phone
2058220067 (Phone)
Billing Details
Address
P.O. Box 1245
Indiana, PA 15701
Billing Phone
7244653496
Specialty Type
Physical Therapy
Map
Address