Contract Details
Southern Medical Equipment
Facility name
ReliaCare Alliance
Provider ID
P000008058
NPI
1790093144
Tax ID
273258348
Effective Date
11/25/2014
Last Updated
12/30/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
Location Details
Address
110 3rd Avenue Southeast
Cullman, AL 35055
United States
County
Cullman
Phone
8773315170 (Phone)
Billing Details
Address
199 Lee Avenue
Suite 876
Brooklyn, NY 11211
Billing Phone
2129569400
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address