Contract Details
Facility name
Eliza Coffee Ambulatory Surgery Center
Provider ID
P000002103
Tax ID
272451336
Effective Date
10/1/1995
Last Updated
6/13/2014
Direct Contract
Yes
Term Date
6/13/2014
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_012
Location Details
Address
205 Marengo Street
Florence, AL 35630
United States
County
Lauderdale
Phone
2567689191 (Phone)
Billing Details
Address
P.O. Box 10005
Florence, AL 35631
Billing Phone
2567689191
Specialty Type
Ambulatory Surgical Facility
Map
Address