MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 1106
Change Report (if Any):

Short Name: SALVATION-CUYA

Long Name 1: THE SALVATION ARMY
Long Name 2:

Address 1: 1710 PROSPECT AVENUE E
Address 2:

City: CLEVELAND
Zip Code: 44115
County: CUYA

Contact: ARTHUR HILL
Title: DIR
Phone: 2167813773
FAX: 2167819535

Vendor: 10090

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016