UPI (Provider ID): 10214
Change Report (if Any):

Short Name: BIG BR/SIS-ROSS

Long Name 1: SOUTH CENTRAL OHIO BIG
Long Name 2: BROTHERS BIG SISTERS ASSO

Address 1: 173 WEST SECOND STREET
Address 2:

City: CHILLICOTHE
Zip Code: 45601
County: ROSS

Contact: KAREN MCDONALD-MYERS
Title: EX DR
Phone: 7407732447
FAX: .

Vendor: 10214

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 02/07/2012

File Produced: 19MAY2012