UPI (Provider ID): 6799
Change Report (if Any):

Short Name: CLEVE HLTH CORR

Long Name 1: CLEVELAND DEPARTMENT OF HEALTH
Long Name 2:

Address 1: MAY DUGAN CENTER
Address 2: 4115 BRIDGE AVENUE

City: CLEVELAND
Zip Code: 44113
County: CUYA

Contact: DAVID GRETICK
Title: PGDIR
Phone: 2166315800
FAX: .

Vendor: 10333

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016