MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10007
Change Report (if Any):

Short Name: OSU-HOSPITALS

Long Name 1: OSU UNIVERSITY HOSPITALS DEPT
Long Name 2: OF PSYCHIATRY UPHAM HALL

Address 1: 1670 UPHAM DRIVE
Address 2:

City: COLUMBUS
Zip Code: 43210
County: FRAN

Contact: SR THORWARD
Title: CEO
Phone: 6142934207
FAX: 6142934504

Vendor: 10007

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012