Contract Details
Premier OrthoSports, Inc.
Facility name
OrthoSports Athens
Provider ID
P000008388
NPI
1679857106
Tax ID
452825086
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
1860 Highway 43
Winfield, AL 35594
United States
County
Fayette
Phone
2054871111 (Phone)
Billing Details
Address
1860 Highway 43
Winfield, AL 35594
Billing Phone
2054871111
Specialty Type
Surgery, Orthopedic
Map
Address