Contract Details
Facility name
Eastern Shore Pain Management
Provider ID
P000002100
Tax ID
710883063
Effective Date
4/15/2004
Last Updated
2/16/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
23690 Highway 98 Suite G
Fairhope, AL 36532
United States
County
Baldwin
Phone
2519292050 (Phone)
Billing Details
Address
23690 Highway 98
Suite G
Fairhope, AL 36532
Billing Phone
2519292050
Specialty Type
Pain Management Facility
Map
Address