Contract Details
Facility name
Southern Patient Care
Provider ID
P000006683
NPI
1134146830
Tax ID
582004338
Effective Date
10/10/2012
Last Updated
3/4/2022
Direct Contract
Yes
Term Date
2/28/2022
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
77.00
Location Details
Address
104 Oxmoor Road Suite 140
Birmingham, AL 35209
United States
County
Jefferson
Phone
2057768323 (Phone)
Billing Details
Address
104 Oxmoor Road
Suite 140
Birmingham, AL 35209
Billing Phone
2057768323
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address