UPI (Provider ID): 13051
Change Report (if Any):

Short Name: SUMMA - CANTON

Long Name 1: SUMMA HEALTH SYSTEM
Long Name 2: IGNATIA HALL SOUTH

Address 1: 3730 WHIPPLE AVENUE NW
Address 2:

City: CANTON
Zip Code: 44718
County: STAR

Contact: GREER KABB-LANGKAMP
Title: MGR
Phone: 3304891233
FAX: 3304891121

Vendor: 1504

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 08/25/2014

File Produced: 14JUL2016