UPI (Provider ID): 1463
Change Report (if Any):

Short Name: SCIOTO PAINT VL

Long Name 1: SCIOTO PAINT VALLEY MHC
Long Name 2:

Address 1: 4449 STATE ROUTE 159
Address 2:

City: CHILLICOTHE
Zip Code: 45601
County: ROSS

Contact: AMI SHAFFER
Title: CLRK
Phone: 7407751260
FAX: 7407731264

Vendor: 1463

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 03/28/2012

File Produced: 19MAY2012