MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 11203
Change Report (if Any):

Short Name: UMADAOP-FRAN CO

Long Name 1: UMADAOP OF FRANKLIN CO INC
Long Name 2:

Address 1: 510 EAST MOUND STREET
Address 2: SUITE 100

City: COLUMBUS
Zip Code: 43215
County: FRAN

Contact: LYNNE MCWHERTER
Title: FINC
Phone: 6142279694
FAX: 6142270370

Vendor: 11203

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/19/2011

File Produced: 19MAY2012