UPI (Provider ID): 1875
Change Report (if Any):

Short Name: LUTHERAN MIN-25

Long Name 1: LUTHERAN METROPOLITAN MINISTRY
Long Name 2:

Address 1: 1468 WEST 25TH STREET
Address 2:

City: CLEVELAND
Zip Code: 44113
County: CUYA

Contact: CHARLES SEE
Title: EXDIR
Phone: 2166962717
FAX: 2166963317

Vendor: 1875

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 01/05/2012

File Produced: 14JUL2016