UPI (Provider ID): 11032
Change Report (if Any):

Short Name: RANJAN - CHARAK

Long Name 1: CHARAK CENTER FOR HEALTH AND
Long Name 2: WELLNESS

Address 1: 801 EAST WASHINGTON STREET
Address 2: SUITE 150

City: MEDINA
Zip Code: 44256
County: MEDI

Contact: RAKESH RANJAN MD
Title:
Phone: 3307221069
FAX: 3307649712

Vendor: 11032

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/21/2011

File Produced: 19MAY2012