Contract Details
Coastal Neurological Institute
Facility name
Coastal Neurological Institute
Provider ID
P000002055
NPI
1740212174
Tax ID
630782200
Effective Date
6/26/2014
Last Updated
2/7/2019
Direct Contract
Yes
Term Date
2/5/2019
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
90.00
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
Diagnostic Services
Map
Address