MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 12479
Change Report (if Any):

Short Name: L & P SERVICES

Long Name 1: L AND P SERVICES INC
Long Name 2:

Address 1: 207 COLEGATE DRIVE
Address 2:

City: MARIETTA
Zip Code: 45750
County: WASH

Contact: BRENT PHIPPS
Title: PRES
Phone: 7403760930
FAX: 7403760933

Vendor: 12479

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012