MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10211
Change Report (if Any):

Short Name: COUNCIL AGING

Long Name 1: MEIGS COUNTY COUNCIL ON AGING
Long Name 2:

Address 1: MULBERRY HEIGHTS
Address 2: PO BOX 722

City: POMEROY
Zip Code: 45769
County: MEIG

Contact: BETH SHAVER
Title: AS DR
Phone: 7409922161
FAX: 7409927886

Vendor: 10211

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012