UPI (Provider ID): 13002
Change Report (if Any):

Short Name: ST VINCENT CHAR

Long Name 1: ST VINCENT CHARITY MEDICAL
Long Name 2: CENTER

Address 1: 2351 E 22ND STREET
Address 2:

City: CLEVELAND
Zip Code: 44115
County: CUYA

Contact: SHARON THOMAS
Title: CNO
Phone: 2168616200
FAX: .

Vendor: 13002

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 03/06/2012

File Produced: 14JUL2016