Contract Details
Coastal Neurological Institute
Facility name
Coastal Neurological Institute
Provider ID
P000002055
NPI
1740212174
Tax ID
630782200
Effective Date
2/6/2019
Last Updated
2/7/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_408
Location Details
Address
3280 Daughin Street Building A
Mobile, AL 36606
United States
County
Mobile
Phone
2514503700 (Phone)
Billing Details
Address
3280 Daughin Street
Building A
Mobile, AL 36606
Billing Phone
2514503700
Specialty Type
Diagnostic Services
Map
Address