UPI (Provider ID): 12556
Change Report (if Any):

Short Name: HLTH RESOURCE

Long Name 1: HEALTH RESOURCE CENTER OF
Long Name 2: CINCINNATI INC

Address 1: 2347 VINE STREET 2ND FL
Address 2:

City: CINCINNATI
Zip Code: 45219
County: HAMI

Contact: CORNELIA WILSON
Title: CEO
Phone: 5133574602
FAX: 5133574696

Vendor: 12556

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/19/2012

File Produced: 19MAY2012