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Contract Details
Facility name
OrthoSports Associates
Provider ID
P000000001
NPI
1851665095
Tax ID
275501752
Effective Date
12/13/2022
Last Updated
1/4/2023
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_508
Exhibit Attachment
Location Details
Address
16233 Highway 280 Suite G
Chelsea, AL 35043
United States
Phone
205-838-3090
(
Phone
)
Billing Details
Address
P.O. Box 11407
Department 2004
Birmingham, AL 35246
Billing Phone
205-838-3090
Specialty Type
Surgery, Orthopedic
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