Contract Details
OrthoSports, LLC
Facility name
OrthoSports Athens
Provider ID
P000008384
NPI
1659715803
Tax ID
452827135
Effective Date
2/17/2016
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
15243 Greenfield Drive Suite A
Athens, AL 35613
United States
County
Limestone
Phone
2562332332 (Phone)
Billing Details
Address
1860 Highway 43
Winfield, AL 35594
Billing Phone
2054871111
Specialty Type
Surgery, Orthopedic
Map
Address