Contract Details
Southeast Alabama Medical Center Clinics
Facility name
Enterprise Medical Clinic
Provider ID
P000002384
NPI
1619026606
Tax ID
636004476
Effective Date
7/1/1995
Last Updated
8/6/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
101 Professional Lane
Enterprise, AL 36330
United States
County
Coffee
Phone
3343473404 (Phone)
Billing Details
Address
101 Professional Lane
Enterprise, AL 36330
Billing Phone
3343473404
Specialty Type
Family Practice
Map
Address