Contract Details
Facility name
St. Vincent's Occupational Health Clinic
Provider ID
P000002390
NPI
1679678577
Tax ID
631129096
Effective Date
2/11/1992
Last Updated
7/20/2020
Direct Contract
No
Term Date
1/21/2020
Status
Contract Discounts
Discount Type
M
Exhibit ID
AM_457
Location Details
Address
1 Lakeshore Drive Suite 301
Birmingham, AL 35209
United States
County
Jefferson
Phone
2059302910 (Phone)
Billing Details
Address
1 Lakeshore Drive
Suite 301
Birmingham, AL 35209
Billing Phone
2059302600
Specialty Type
Occupational Medicine Facility
Map
Address