UPI (Provider ID): 11028
Change Report (if Any):

Short Name: UNITED METH CHI

Long Name 1: UNITED METHODIST
Long Name 2: CHILDRENS HOME

Address 1: 1033 HIGH STREET
Address 2:

City: WORTHINGTON
Zip Code: 430854054
County: FRAN

Contact: DAVID ALLEN KURTZ
Title: CFO
Phone: 6148855020
FAX: 6148854058

Vendor: 11028

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/19/2011

File Produced: 19MAY2012