UPI (Provider ID): 10171
Change Report (if Any):

Short Name: ERIE SHORE

Long Name 1: ERIE SHORE NETWORK
Long Name 2:

Address 1: 326 EAST MARKET STREET
Address 2: PO BOX 1606

City: SANDUSKY
Zip Code: 44870
County: ERIE

Contact: BETTY MARSHALL
Title: EX DR
Phone: 4196262006
FAX: 4196264013

Vendor: 10171

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012