UPI (Provider ID): 2334
Change Report (if Any):

Short Name: MVH INPT-BNFREE

Long Name 1: MIAMI VALLEY HOSPITAL
Long Name 2: BORN FREE

Address 1: ONE WYOMING STREET
Address 2:

City: DAYTON
Zip Code: 454092711
County: MONT

Contact: RIC MCALLISTER
Title: DIR
Phone: 9372082536
FAX: 9373418153

Vendor: 2334

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012