Contract Details
Facility name
Coastal Neurological Institute
Provider ID
P000002055
NPI
1740212174
Tax ID
630782200
Effective Date
12/1/1999
Last Updated
6/30/2014
Direct Contract
Yes
Term Date
6/25/2014
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
3280 Dauphin Street Building A
Mobile, AL 36606
United States
County
Mobile
Phone
2514503700 (Phone)
Billing Details
Address
3280 Dauphin Street
Building A
Mobile, AL 36606
Billing Phone
2514503700
Specialty Type
Surgery, Neurological
Map
Address