Contract Details
Facility name
Southern Patient Care
Provider ID
P000006687
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
560 Weathersby Road
Hattiesburg, MS 39402
United States
County
Lamar
Phone
6015798585 (Phone)
Billing Details
Address
560 Weathersby Road
Hattiesburg, MS 39402
Billing Phone
6015798585
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address