UPI (Provider ID): 12767
Change Report (if Any):

Short Name: CATH CHAR-GEAU

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

Address 1: 10771 MAYFIELD ROAD
Address 2:

City: CHARDON
Zip Code: 44024
County: GEAU

Contact: VICKI CHINCHAR
Title: ACCT
Phone: 4402853537
FAX: 4402854909

Vendor: 10092

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/17/2013

File Produced: 14JUL2016