MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10686
Change Report (if Any):

Short Name: ASTOP INC

Long Name 1: ASTOP INC
Long Name 2:

Address 1: 1519 NORTH MAIN STREET
Address 2:

City: LIMA
Zip Code: 45801
County: ALLE

Contact: CAROL GRADY
Title: EXDIR
Phone: 4192224557
FAX: 4192248608

Vendor: 11004

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012