Contract Details
Elite Rehab, Inc.
Facility name
Elite Rehab, Inc.
Provider ID
P000008681
NPI
1609310853
Tax ID
471891674
Effective Date
4/12/2017
Last Updated
10/25/2019
Direct Contract
Yes
Term Date
10/25/2019
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
405 East Barbour St. Suite 5
Eufaula, AL 36027
United States
County
Barbour
Phone
3346879831 (Phone)
Billing Details
Address
1636 Mulberry St.
Montgomery, AL 36106
Billing Phone
3342653199
Specialty Type
Physical Therapy
Map
Address