Contract Details
Foley Clinic Corporation
Facility name
Gulf Coast Occupational, Sports & Pain Medicine
Provider ID
P000002170
NPI
1427296029
Tax ID
621822362
Effective Date
2/15/2009
Last Updated
3/3/2016
Direct Contract
Yes
Term Date
1/31/2015
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
1615 North Alston Street
Foley, AL 36535
United States
County
Baldwin
Phone
2519232050 (Phone)
Billing Details
Address
7100 Commerce Way
Suite 180
Brentwood, TN 37027
Billing Phone
6154657000
Specialty Type
General Practice
Map
Address