Contract Details
Facility name
Nutritional Parenteral Home Care
Provider ID
P000002286
NPI
1144498247
Tax ID
631284325
Effective Date
7/8/2009
Last Updated
9/3/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
2601 Emogene Street Suite B
Mobile, AL 36606
United States
County
Mobile
Phone
2514761866 (Phone)
Billing Details
Address
P.O. Box 534411
Atlanta, GA 30353
Billing Phone
2514761866
Specialty Type
Home Infusion
Map
Address