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Contract Details
CRMC Medical Group, LLC
Facility name
Hartselle Health Park Imaging Center
Provider ID
P000000001
Tax ID
462447900
Effective Date
10/1/2021
Last Updated
11/18/2021
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1549 US-31
Hartselle, AL 35640
United States
Phone
2567355920
(
Phone
)
Billing Details
Address
P.O. Box 2895
Cullman, AL 35056
Billing Phone
256-737-2090
Specialty Type
Diagnostic Services
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