Contract Details
Facility name
Southern Pain Control Center
Provider ID
P000002430
NPI
1104976695
Tax ID
581970770
Effective Date
10/25/2005
Last Updated
9/3/2015
Direct Contract
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
7205 Copperfield Drive
Montgomery, AL 36117
United States
County
Montgomery
Phone
3343966055 (Phone)
Billing Details
Address
2257 Taylor Road
Suite 200
Montgomery, AL 36117
Billing Phone
Specialty Type
Pain Management Facility
Map
Address