UPI (Provider ID): 10223
Change Report (if Any):

Short Name: ELDERLY UNITED

Long Name 1: ELDERLY UNITED OF SPRINGFIELD
Long Name 2: AND CLARK COUNTY OHIO INC

Address 1: 50 WEST HIGH STREET
Address 2:

City: SPRINGFIELD
Zip Code: 45502
County: CLAR

Contact: JOYCE WARE
Title:
Phone: 9373234948
FAX: 9373249005

Vendor: 10223

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/20/2011

File Produced: 19MAY2012