Contract Details
BH BHC, LLC
Facility name
Childersburg Wound Care Clinic
Provider ID
474757851
NPI
P000009287
Tax ID
474757851
Effective Date
1/1/2020
Last Updated
12/23/2020
Direct Contract
Yes
Term Date
12/31/2020
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_436
Location Details
Address
34011 Highway 280 East
Childersburg, AL 35044
United States
Phone
2058771000 (Phone)
Billing Details
Address
34011 Highway 280 East
Childersburg, AL 35044
Billing Phone
2058771000
Specialty Type
Wound Care & Hyperbaric Oxygen Therapy