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Contract Details
Alabama Providence Healthcare
Facility name
Alabama Providence Healthcare
Provider ID
P000009140
Tax ID
462847744
Effective Date
1/10/2018
Last Updated
5/9/2018
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
5100 Rangeline Service Road N
Mobile, AL 36619
United States
County
Mobile
Phone
2513784000
(
Phone
)
Billing Details
Address
5100 Rangeline Service Road N
Mobile, AL 36619
Billing Phone
2513784000
Specialty Type
Occupational Medicine Facility
Map
Address