UPI (Provider ID): 1567
Change Report (if Any):

Short Name: WOMEN-STORER

Long Name 1: THE WOMENS CENTER
Long Name 2: OF GREATER CLEVELAND

Address 1: 6209 STORER AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44102
County: CUYA

Contact: MARY JANE CHICHESTER
Title: EXDIR
Phone: 2166511450
FAX: 2166514351

Vendor: 1567

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/09/2011

File Produced: 14JUL2016