MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10494
Change Report (if Any):

Short Name: JEWISH FAM SRVS

Long Name 1: JEWISH FAMILY SERVICES
Long Name 2:

Address 1: 1070 COLLEGE AVENUE
Address 2:

City: COLUMBUS
Zip Code: 43209
County: FRAN

Contact: MARLA VUCIC
Title:
Phone: 6142311890
FAX: 6142314978

Vendor: 10494

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/19/2011

File Produced: 19MAY2012