Contract Details
Trinity Development, LLC
Facility name
South Alabama Outpatient Services
Provider ID
P000000001
NPI
1013924133
Tax ID
721376946
Effective Date
1/15/2025
Last Updated
1/21/2025
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_550
Location Details
Address
201 E Watts Street
Enterprise, AL 36330
United States
Phone
334-393-5474 (Phone)
Billing Details
Address
201 E Watts Street
Enterprise, AL 36330
Billing Phone
334-393-5474
Specialty Type
Ambulatory Surgical Facility
Map
Address