MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 12208
Change Report (if Any):

Short Name: SINCLAIR SEP

Long Name 1: SINCLAIR COMMUNITY COLLEGE
Long Name 2: SUPPORTED EDUCATION PROGRAM

Address 1: 444 WEST THIRD STREET
Address 2:

City: DAYTON
Zip Code: 45402
County: MONT

Contact: DEAN COLE
Title: MGR
Phone: 9375127097
FAX: 9375124521

Vendor: 12208

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012