Contract Details
Facility name
Columbiana Clinic
Provider ID
P000000001
NPI
1356492904
Tax ID
582621638
Effective Date
12/5/2023
Last Updated
12/12/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
22266 Highway 25
Columbiana, AL 35051
United States
Phone
205-669-3138 (Phone)
Billing Details
Address
22266 Highway 25
Columbiana, AL 35051
Billing Phone
205-669-3138
Specialty Type
Family Practice
Website
Visit Website
Map
Address