Contract Details
PMCOA, Inc.
Facility name
Health Star Clinic
Provider ID
P000008210
NPI
1003901380
Tax ID
455119160
Effective Date
3/13/2015
Last Updated
3/31/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
3283 Malcolm Drive
Montgomery, AL 36116
United States
County
Montgomery
Phone
3348331010 (Phone)
Billing Details
Address
P.O. Box 341467
Montgomery, AL 36124
Billing Phone
3343561111
Specialty Type
Chiropractic Medicine
Map
Address