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Contract Details
Facility name
Selma Urgent Care
Provider ID
P000008029
NPI
1801157706
Tax ID
455425534
Effective Date
9/16/2014
Last Updated
2/9/2016
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1025 Medical Center Parkway
Selma, AL 36701
United States
County
Dallas
Phone
3348758833
(
Phone
)
Billing Details
Address
1025 Medical Center Parkway
Selma, AL 36701
Billing Phone
3348758833
Specialty Type
Urgent Care Facility
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Address