MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 2340
Change Report (if Any):

Short Name: HELP CENTER

Long Name 1: HENRY COUNTY HOSPITAL
Long Name 2: HELP CENTER

Address 1: 11 600 STATE ROUTE 424
Address 2:

City: NAPOLEON
Zip Code: 43545
County: HENR

Contact: KATHLEEN CLAYTON
Title: BSN
Phone: 4195924015
FAX: 4195924017

Vendor: 2340

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012