Contract Details
Facility name
Southern Pain and Rehab
Provider ID
P000007440
NPI
1679871321
Tax ID
275204210
Effective Date
5/25/2011
Last Updated
4/1/2016
Direct Contract
Yes
Term Date
4/1/2016
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1815 Hand Avenue
Bay Minette, AL 36507
United States
County
Baldwin
Phone
2516260901 (Phone)
Billing Details
Address
1815 Hand Avenue
Bay Minette, AL 36507
Billing Phone
2516260901
Specialty Type
Pain Management Facility
Map
Address