Contract Details
Prime Med
Facility name
Prime Med
Provider ID
P000009456
NPI
1033495221
Tax ID
202533369
Effective Date
11/27/2019
Last Updated
11/27/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1970 Andrews Avenue
Ozark, AL 36360
United States
County
Dale
Phone
3347741555 (Phone)
Billing Details
Address
1970 Andrews Avenue
Ozark, AL 36360
Billing Phone
Specialty Type
Neurology
Map
Address