MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 12968
Change Report (if Any):

Short Name: PEOPLE TO PEOPL

Long Name 1: PEOPLE TO PEOPLE
Long Name 2:

Address 1: 1200 WHEELING AVENUE
Address 2:

City: CAMBRIDGE
Zip Code: 43725
County: GUER

Contact: ALICIA W AMATO
Title: EXDIR
Phone: 7404321800
FAX: 7404321801

Vendor: 12968

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/14/2011

File Produced: 19MAY2012