Contract Details
Bayside Orthopedic & Rehabilitation Center, P.C.
Facility name
Bayside Orthopaedic, Sports Medicine & Rehabilitation Center
Provider ID
P000002011
NPI
1215014097
Tax ID
630730089
Effective Date
6/1/1996
Last Updated
10/6/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_158
Location Details
Address
341 North Greeno Road
Fairhope, AL 36532
United States
County
Baldwin
Phone
2519282401 (Phone)
Billing Details
Address
P.O. Box 1186
Fairhope, AL 36532
Billing Phone
2519282401
Specialty Type
Surgery, Orthopedic
Map
Address