MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10145
Change Report (if Any):

Short Name: NW COMM ACTION

Long Name 1: NORTHWESTERN OHIO COMMUNITY
Long Name 2: ACTION COMMISSION

Address 1: 1933 EAST SECOND STREET
Address 2:

City: DEFIANCE
Zip Code: 43512
County: DEFI

Contact: KIM REED
Title: FIN
Phone: 4197842150
FAX: 4197825648

Vendor: 10145

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012