Contract Details
MedCenter Fayette, LLC
Facility name
MedCenter Fayette
Provider ID
P000009012
NPI
1235590001
Tax ID
371803427
Effective Date
11/14/2017
Last Updated
11/16/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
122 17th Court NE
Fayette, AL 35555
United States
County
Fayette
Phone
2059327777 (Phone)
Billing Details
Address
122 17th Court NE
Fayette, AL 35555
Billing Phone
2059327777
Specialty Type
Urgent Care Facility
Map
Address