UPI (Provider ID): 6713
Change Report (if Any):

Short Name: GLENBEIGH-ROCKC

Long Name 1: GLENBEIGH HOSPITAL AND
Long Name 2: OUTPATIENT CENTERS

Address 1: 2863 STATE ROUTE 45
Address 2:

City: ROCK CREEK
Zip Code: 440840298
County: ASHT

Contact: PAT WESTON HALL
Title: EX DR
Phone: 4405633400
FAX: 4405639619

Vendor: 6713

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/21/2011

File Produced: 14JUL2016