UPI (Provider ID): 1366
Change Report (if Any):

Short Name: MERIDIAN SERV

Long Name 1: MERIDIAN COMMUNITY CARE
Long Name 2:

Address 1: 527 NORTH MERIDIAN ROAD
Address 2:

City: YOUNGSTOWN
Zip Code: 44509
County: MAHO

Contact: LAWRENCE MOLITERNO
Title: CEO
Phone: 3307970070
FAX: 3307979148

Vendor: 1366

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/20/2011

File Produced: 19MAY2012