Contract Details
Facility name
TherapySouth Fultondale
Provider ID
P000000001
NPI
1972787687
Tax ID
320221578
Effective Date
2/15/2012
Last Updated
2/9/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
3471 Lowery Parkway Suite 107
Fultondale, AL 35068
United States
Phone
205-849-6566 (Phone)
Billing Details
Address
2823 Greystone Commercial Blvd
Birmingham, AL 35242
Billing Phone
205-745-3660
Specialty Type
Occupational Therapy Facility
Website
Visit Website
Workers Comp Coordinator
Mary
Holden
mholden@therapysouth.net
Map
Address