UPI (Provider ID): 10229
Change Report (if Any):

Short Name: MH TAYLOR-MARYM

Long Name 1: MURTIS H TAYLOR
Long Name 2: MARYMOUNT

Address 1: 12395 MCCRACKEN ROAD
Address 2:

City: GARFIELD HEIGHTS
Zip Code: 44125
County: CUYA

Contact: TITUS MUNYASYA
Title:
Phone: 2166635338
FAX: 2166636021

Vendor: 3042

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016