UPI (Provider ID): 2292
Change Report (if Any):

Short Name: URBAN OZ PREVEN

Long Name 1: URBAN OUNCE OF PREVENTION
Long Name 2: SERVICES

Address 1: 1735 S HAWKINS AVE SUITE B
Address 2:

City: AKRON
Zip Code: 443204055
County: SUMM

Contact: ALEXANDER CAGLE
Title: COORD
Phone: 3308675400
FAX: 3308698263

Vendor: 2292

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/29/2011

File Produced: 14JUL2016