Contract Details
Facility name
Covington Family Care
Provider ID
P000007181
NPI
1427263227
Tax ID
631209008
Effective Date
7/15/2009
Last Updated
12/5/2017
Direct Contract
Yes
Term Date
9/30/2017
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
508 East Three Notch Street
Andalusia, AL 36420
United States
County
Covington
Phone
3344272273 (Phone)
Billing Details
Address
P.O. Box 310
Andalusia, AL 36420
Billing Phone
3344272273
Specialty Type
Family Practice
Map
Address