UPI (Provider ID): 10247
Change Report (if Any):

Short Name: BRIDGEWAY-LAKEW

Long Name 1: BRIDGEWAY INC
Long Name 2:

Address 1: 14050 MADISON AVENUE
Address 2:

City: LAKEWOOD
Zip Code: 44107
County: CUYA

Contact: GENISE HERBERT
Title:
Phone: 2165212212
FAX: 2165218944

Vendor: 10509

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016