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Contract Details
Greater Mobile Urgent Care
Facility name
Greater Mobile Urgent Care - Citronelle
Provider ID
P000007752
NPI
1164794343
Tax ID
454405573
Effective Date
5/1/2014
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
19355 North 3rd Street Suite 104
Citronelle, AL 36522
United States
County
Mobile
Phone
2516330123
(
Phone
)
Billing Details
Address
7943 Moffett Road
Semmes, AL 36575
Billing Phone
2516330123
Specialty Type
Urgent Care Facility
Map
Address