Contract Details
Facility name
Advanced Wound Care and Limb Preservation
Provider ID
P000008279
NPI
1356685416
Tax ID
455602876
Effective Date
5/19/2015
Last Updated
7/15/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
300 Dauphin Street Building 2, Suite 600
Mobile, AL 36608
United States
County
Mobile
Phone
2514547802 (Phone)
Billing Details
Address
300 Dauphin Street
Building 2, Suite 600
Mobile, AL 36608
Billing Phone
2514547802
Specialty Type
Wound Care and Hyperbaric Medicine
Map
Address