Contract Details
One Call Care Management
Facility name
Coastal Neurological Institute
Provider ID
P000002055
NPI
1740212174
Tax ID
223218521
Effective Date
6/1/1999
Last Updated
5/21/2017
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_059
Location Details
Address
3280 Dauphin Street Building A
Mobile, AL 36606
United States
County
Mobile
Phone
8008722875 (Phone)
Billing Details
Address
P.O. Box 614
Parsippany, NJ 07054
Billing Phone
8008722875
Specialty Type
Diagnostic Services
Map
Address