Contract Details
Temporarily Not Taking WC 02/2023
Facility name
Eastern Shore Adult Medicine - Infirmary Medical Clinics
Provider ID
P000000001
Tax ID
453455739
Effective Date
10/7/2022
Last Updated
2/6/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
300 Greeno Road South Suite B
Fairhope, AL 36532
United States
Phone
251-929-3424 (Phone)
Billing Details
Address
300 Greeno Road South
Suite B
Fairhope, AL 36532
Billing Phone
251-929-3424
Specialty Type
Family Practice
Map
Address