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Contract Details
Fast360, LLC
Facility name
Shelby Baptist Medical Center
Provider ID
P000002569
NPI
1053403220
Tax ID
460926698
Effective Date
1/1/2017
Last Updated
8/14/2017
Direct Contract
No
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_312
AM_312
Location Details
Address
1000 1st Street North
Alabaster, AL 35007
United States
County
Shelby
Phone
8666746728
(
Phone
)
Billing Details
Address
761 Old Hickory Boulevard
Suite 300
Brentwood, TN 37027
Billing Phone
8666746728
Specialty Type
Diagnostic Services
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Address