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Contract Details
Facility name
University of Alabama Health Services Foundation, P.C.
Provider ID
P000000001
Tax ID
630649108
Effective Date
4/1/1996
Last Updated
6/11/2024
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
125 20th Street South Suite 103
Birmingham, AL 35233
United States
Phone
205-801-5251
(
Phone
)
Billing Details
Address
P.O. Box 55309
Birmingham, AL 35255
Billing Phone
205-934-9999
Specialty Type
Orthotics/Prosthetics, Services
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Address