Vaughn  H  Mancha    MD
Contract Details
Infirmary Health Urgent Care--Gulf Shores
Facility name
Provider ID
P000003579
NPI
1184738668
Tax ID
454845231
Effective Date
10/30/1992
Last Updated
4/20/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
1140 Gulf Shores Parkway
Gulf Shores, AL 36542
United States
County
Baldwin
Phone
2519682273 (Phone)
Billing Details
Address
1140 Gulf Shores Parkway
Gulf Shores, AL 36542
Billing Phone
2519682273
Specialty Type
Family Practice
Map
Address