UPI (Provider ID): 1100
Change Report (if Any):

Short Name: HITCHCOCK CNTR

Long Name 1: HITCHCOCK CENTER FOR WOMEN
Long Name 2:

Address 1: 1227 ANSEL ROAD
Address 2:

City: CLEVELAND
Zip Code: 44108
County: CUYA

Contact: MARY BAZIE
Title: EXDIR
Phone: 2164210662
FAX: 2164210911

Vendor: 1100

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/21/2011

File Produced: 14JUL2016