Contract Details
Facility name
Gateway Pharmaceuticals
Provider ID
P000008056
NPI
1619313079
Tax ID
462336104
Effective Date
12/15/2014
Last Updated
3/4/2022
Direct Contract
Yes
Term Date
2/28/2022
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_235
Location Details
Address
3532 Vann Road Suite 106-B
Birmingham, AL 35235
United States
County
Jefferson
Phone
2055085500 (Phone)
Billing Details
Address
3532 Vann Road
Suite 106-B
Birmingham, AL 35235
Billing Phone
2055085500
Specialty Type
Pharmacy
Map
Address