Contract Details
Facility name
Outpatient Diagnostic Center of Huntsville
Provider ID
P000002313
NPI
1811945306
Tax ID
631280228
Effective Date
12/6/2012
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_125
Location Details
Address
115 Saint Clair Avenue Southeast
Huntsville, AL 35801
United States
County
Madison
Phone
2565345600 (Phone)
Billing Details
Address
P.O. Box 637237
Cincinnati, OH 45263
Billing Phone
8665915559
Specialty Type
Diagnostic Services
Map
Address