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Nancy
E
Medeiros
MD
Contract Details
Retina & Vitreous Associates of Alabama
Facility name
Provider ID
P000001137
NPI
1427086404
Tax ID
631159547
Effective Date
9/1/1998
Last Updated
5/5/2014
Direct Contract
Yes
Term Date
8/14/2013
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
216 South Marengo Street Unit K
Florence, AL 35630
United States
County
Lauderdale
Phone
2567400601
(
Phone
)
Billing Details
Address
P.O. Box 10992
Birmingham, AL 35202
Billing Phone
2567400601
Specialty Type
Ophthalmology
Map
Address