Contract Details
Facility name
Coastal Therapeutics
Provider ID
P000002056
NPI
1356434906
Tax ID
753039795
Effective Date
11/1/2003
Last Updated
9/3/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1234 Hillcrest Road Suite A
Mobile, AL 36695
United States
County
Mobile
Phone
2516336235 (Phone)
Billing Details
Address
1234 Hillcrest Road
Suite A
Mobile, AL 36695
Billing Phone
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address