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Contract Details
Facility name
Vyas & Vyas
Provider ID
P000002502
NPI
1528255601
Tax ID
630781454
Effective Date
10/30/1994
Last Updated
6/10/2014
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
109 Medical Park Drive Suite B
Andalusia, AL 36420
United States
County
Covington
Phone
3342226041
(
Phone
)
Billing Details
Address
P.O. Box 1105
Andalusia, AL 36420
Billing Phone
3342226041
Specialty Type
General Practice
Map
Address