UPI (Provider ID): 12764
Change Report (if Any):

Short Name: CATH CHAR-MEDI

Long Name 1: CATHOLIC CHARITIES OF
Long Name 2: MEDINA COUNTY

Address 1: 740 EAST WASHINGTON ST
Address 2:

City: MEDINA
Zip Code: 44256
County: MEDI

Contact: KATHY WALBURN
Title: BUSMG
Phone: 3307239615
FAX: 3307648795

Vendor: 10092

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 01/17/2013

File Produced: 14JUL2016