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Contract Details
Facility name
Providence Medical Center
Provider ID
P000002560
NPI
1952390643
Tax ID
630288861
Effective Date
5/15/2019
Last Updated
10/3/2023
Direct Contract
Yes
Term Date
9/30/2023
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_419
AM_419
Location Details
Address
6801 Airport Boulevard
Mobile, AL 36608
United States
County
Mobile
Phone
2516331000
(
Phone
)
Billing Details
Address
6801 Airport Boulevard
Mobile, AL 36608
Billing Phone
2516331600
Specialty Type
Hospital, Acute Care
Map
Address