| Prov Contract Info-Service Location |
The provider contract information panel provides users the ability to view basic provider service location information.
Navigation Path: [Provider Enrollment] - [Provider Contract Status] - [Search] - [Select Row]
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| Field Descriptions: |
| Address 1 | Displays the first line of the provider's service location address. (Read-Only) |
| Address 2 | Displays the second line of the provider's service location address. (Read-Only) |
| City, State | Displays the city and state of the provider's service location address. (Read-Only) |
| Email Address | Displays the email address for the provider. (Read-Only) |
| Fax Number | Displays the fax number for the provider. |
| Name | Displays the name of the provider. (Read-Only) |
| Phone Number | Displays the phone number for the provider. (Read-Only) |
| Provider Reference ID | Displays the reference ID of the provider. (Read-Only) |
| Provider Type | Displays the description of the type of provider. (Read-Only) |
| Zip | Displays the zip code and zip code extension of the provider's service location address. (Read-Only) |
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| (No field edits exist) |
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