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Contract Details
Professional Resources Management, Inc.
Facility name
Perfect Kids and Family Care
Provider ID
P000009074
NPI
1194903997
Tax ID
631070858
Effective Date
2/5/2018
Last Updated
9/26/2018
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
308 Prairie Street N
Union Springs, AL 36089
United States
County
Bullock
Phone
3347381499
(
Phone
)
Billing Details
Address
308 Prairie Street N
Union Springs, AL 36089
Billing Phone
3347381499
Specialty Type
Urgent Care Facility
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