Contract Details
Facility name
Montevallo Family Medicine
Provider ID
P000000001
NPI
1720009962
Tax ID
030416268
Effective Date
5/20/2021
Last Updated
6/7/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
33 Salem Road Suite 1
Montevallo, AL 35115
United States
Phone
205-665-7991 (Phone)
Billing Details
Address
33 Salem Road
Suite 1
Montevallo, AL 35115
Billing Phone
205-665-7991
Specialty Type
Family Practice
Map
Address