Contract Details
Professional Resource Management of Wiregrass
Facility name
Alabama Clinics
Provider ID
P000009455
NPI
1801163506
Tax ID
202533369
Effective Date
11/27/2019
Last Updated
8/31/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
2812 Hartford Highway
Dothan, AL 36305
United States
County
Houston
Phone
3347121170 (Phone)
Billing Details
Address
2812 Hartford Highway
Dothan, AL 36305
Billing Phone
3347121170
Specialty Type
Urgent Care Facility
Map
Address