Contract Details
Crestwood Physician Services, LLC
Facility name
Crestwood Family Practice
Provider ID
P000008434
Tax ID
273920921
Effective Date
5/18/2016
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
333 Whitesport Drive Southwest Suite 200
Huntsville, AL 35801
United States
County
Madison
Phone
2564295248 (Phone)
Billing Details
Address
P.O. Box 689022
Franklin, TN 37068
Billing Phone
6154657000
Specialty Type
Family Practice
Map
Address