Contract Details
Facility name
Pell City Internal and Family Medicine
Provider ID
P000008375
NPI
1649539610
Tax ID
454294355
Effective Date
1/20/2016
Last Updated
6/8/2021
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
41 Emience Way Suite A
Pell City, AL 35128
United States
County
Saint Clair
Phone
2058849000 (Phone)
Billing Details
Address
41 Emience Way
Suite A
Pell City, AL 35128
Billing Phone
2058849000
Specialty Type
Family Practice
Map
Address