UPI (Provider ID): 1534
Change Report (if Any):

Short Name: MARIETTA HOSP

Long Name 1: MARIETTA MEMORIAL HOSPITAL
Long Name 2: CENTER FOR CHEMICAL DEPENDENCY

Address 1: 401 MATTHEW STREET
Address 2:

City: MARIETTA
Zip Code: 45750
County: WASH

Contact: CHARLES HASSE
Title: DIR
Phone: 7403738816
FAX: 7403741618

Vendor: 1534

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012