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Contract Details
Facility name
Jackson Surgery Center
Provider ID
P000002219
NPI
1336375930
Tax ID
204173305
Effective Date
2/1/1998
Last Updated
6/24/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_076
AM_076
Location Details
Address
1725 Park Place
Montgomery, AL 36106
United States
County
Montgomery
Phone
3342938484
(
Phone
)
Billing Details
Address
1725 Park Place
Montgomery, AL 36106
Billing Phone
3342938484
Specialty Type
Ambulatory Surgical Facility
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Address