Contract Details
Facility name
Freeman's Compounding Pharmacy
Provider ID
P000007958
NPI
1063826816
Tax ID
464264075
Effective Date
7/14/2014
Last Updated
3/4/2022
Direct Contract
Yes
Term Date
2/28/2022
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
5962 Deer Crest Lane
Trussville, AL 35173
United States
County
Jefferson
Phone
2059728328 (Phone)
Billing Details
Address
5962 Deer Crest Lane
Trussville, AL 35173
Billing Phone
2059728328
Specialty Type
Pharmacy