Stephanie    Harle    RPT
Contract Details
Infirmary Health System
Facility name
Provider ID
P000000713
NPI
1386795557
Tax ID
200978395
Effective Date
8/18/1992
Last Updated
4/7/2014
Direct Contract
Yes
Term Date
4/7/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
305 North Water Street
Mobile, AL 36602
United States
County
Mobile
Phone
2514315800 (Phone)
Billing Details
Address
305 North Water Street
Mobile, AL 36602
Billing Phone
2514315800
Specialty Type
Physical Therapy
Map
Address