Contract Details
USA Healthcare Authority
Facility name
Primary Care Center Street
Provider ID
P000000001
NPI
1508392432
Tax ID
821388539
Effective Date
4/16/2024
Last Updated
5/7/2024
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1601 Center Street Suite 2N
Mobile, AL 36604
United States
Phone
251-434-3475 (Phone)
Billing Details
Address
1601 Center Street
Suite 2N
Mobile, AL 36604
Billing Phone
251-434-3475
Specialty Type
Family Practice
Map
Address