MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 8039
Change Report (if Any):

Short Name: B-W COLLEGE

Long Name 1: BALDWIN WALLACE COLLEGE
Long Name 2: BINGE DRINKING PREVENTION

Address 1: 275 EASTLAND ROAD
Address 2:

City: BEREA
Zip Code: 44017
County: CUYA

Contact: MARC WEST
Title:
Phone: 4408262356
FAX: 4408263484

Vendor: 8039

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016