Contract Details
Enterprise Clinic, LLC
Facility name
Hartford Family Care
Provider ID
P000007711
Tax ID
271826294
Effective Date
2/1/2014
Last Updated
7/27/2020
Direct Contract
Yes
Term Date
7/27/2020
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
106.00
Fee Schedule Multiplier
Location Details
Address
169 North 2nd Avenue
Hartford, AL 36344
United States
County
Geneva
Phone
3343488818 (Phone)
Billing Details
Address
169 North 2nd Avenue
Belfast, ME 36344
Billing Phone
3343488818
Specialty Type
Family Practice
Map
Address