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Contract Details
St. Vincent's Ascension
Facility name
St. Vincent's Trussville Imaging Services
Provider ID
P000000001
NPI
1982121513
Tax ID
815393966
Effective Date
5/18/2018
Last Updated
5/7/2024
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_382
Exhibit Attachment
Location Details
Address
7201 Happy Hollow Road
Trussville, AL 35173
United States
Phone
205-508-6210
(
Phone
)
Fax
205-508-6267
Billing Details
Address
7201 Happy Hollow Road
Trussville, AL 35173
Billing Phone
205-508-6210
Specialty Type
Diagnostic Services
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