Contract Details
Facility name
Southern Patient Care
Provider ID
P000006683
NPI
1134146830
Tax ID
582004338
Effective Date
10/10/2012
Last Updated
2/5/2014
Direct Contract
Yes
Term Date
2/5/2014
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
77.00
Location Details
Address
2806 Wills Creek Road
Gadsden, AL 35904
United States
County
Etowah
Phone
8888804772 (Phone)
Billing Details
Address
2806 Wills Creek Road
Gadsden, AL 35904
Billing Phone
8888804772
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address