MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10148
Change Report (if Any):

Short Name: FIRST CALL-HENR

Long Name 1: FIRST CALL FOR HELP INC
Long Name 2:

Address 1: 600 FREEDOM DRIVE
Address 2:

City: NAPOLEON
Zip Code: 435451024
County: HENR

Contact: LYNDA SHEETS
Title: FINDR
Phone: 4195991660
FAX: 4195928336

Vendor: 10148

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012