UPI (Provider ID): 10426
Change Report (if Any):

Short Name: MH TAYLOR-E 139

Long Name 1: MURTIS H TAYLOR MULTI SERVICES
Long Name 2: CENTER

Address 1: 3244 EAST 139TH STREET
Address 2:

City: CLEVELAND
Zip Code: 44120
County: CUYA

Contact: PHYLLIS DUKES
Title: CPO
Phone: 2162834400
FAX: 2162835359

Vendor: 3042

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016