Contract Details
Facility name
Southern Medical
Provider ID
P000002424
NPI
1770597262
Tax ID
631138283
Effective Date
3/15/2002
Last Updated
9/3/2015
Direct Contract
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_075
Location Details
Address
2159 Rocky Ridge Road Suite 123
Hoover, AL 35216
United States
County
Jefferson
Phone
2058221972 (Phone)
Billing Details
Address
2159 Rocky Ridge Road
Suite 123
Birmingham, AL 35216
Billing Phone
Specialty Type
Home Infusion
Map
Address