UPI (Provider ID): 10125
Change Report (if Any):

Short Name: CENTRAL CLINIC

Long Name 1: CENTRAL CLINIC
Long Name 2:

Address 1: 311 ALBERT SABIN WAY
Address 2:

City: CINCINNATI
Zip Code: 452292801
County: HAMI

Contact: FREDERICK SANDERS
Title: CFO
Phone: 5135589015
FAX: 5135583880

Vendor: 10125

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 01/17/2012

File Produced: 19MAY2012