Contract Details
Facility name
Providence Medical Center
Provider ID
P000002560
NPI
1952390643
Tax ID
630288861
Effective Date
9/1/2001
Last Updated
5/29/2019
Direct Contract
Term Date
5/14/2019
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_040
Location Details
Address
6801 Airport Boulevard
Mobile, AL 36608
United States
County
Mobile
Phone
2516331000 (Phone)
Billing Details
Address
P.O. Box 850429
Mobile, AL 36685
Billing Phone
Specialty Type
Hospital, Acute Care
Map
Address