Contract Details
USA Health System
Facility name
University of South Alabama Health Services Foundation
Provider ID
P000002485
NPI
1386705267
Tax ID
630725648
Effective Date
9/25/2005
Last Updated
10/23/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2451 Fillingim Street Suite 509
Mobile, AL 36617
United States
County
Mobile
Phone
2514717919 (Phone)
Billing Details
Address
P.O. Box 40480
Mobile, AL 36604
Billing Phone
2514717919
Specialty Type
Multi-Specialty Practice
Map
Address