Breena    Till    CRNP
Contract Details
Andalusia Family Walk - In Clinic
Facility name
Provider ID
P000009279
NPI
1376976183
Tax ID
208016585
Effective Date
12/5/2018
Last Updated
12/19/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
95.00
Location Details
Address
301 Medical Avenue Suite A
Andalusia, AL 36420
United States
County
Covington
Phone
3344282273 (Phone)
Billing Details
Address
P.O. Box 1720
Andalusia, AL 36420
Billing Phone
3344282273
Specialty Type
Urgent Care
Map
Address