Contract Details
Dura-Med Southeast, Inc.
Facility name
Flomaton Pharmacy
Provider ID
P000002142
NPI
1144251943
Tax ID
593613176
Effective Date
8/25/2011
Last Updated
6/10/2016
Direct Contract
Yes
Term Date
7/1/2012
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
174 Highway 113
Flomaton, AL 36441
United States
County
Escambia
Phone
2512964224 (Phone)
Billing Details
Address
P.O. Box 5047
Meridian, MS 39302
Billing Phone
6014827420
Specialty Type
Home Infusion
Map
Address