UPI (Provider ID): 12186
Change Report (if Any):

Short Name: AIDS TASKFORCE

Long Name 1: AIDS TASKFORCE OF GREATER
Long Name 2: CLEVELAND

Address 1: 3210 EUCLID AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44115
County: CUYA

Contact: MICHAEL FLICKINGER
Title: DIRFN
Phone: 2166210766
FAX: 2166227788

Vendor: 12186

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016