MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 3144
Change Report (if Any):

Short Name: GEAUGA SHERIFF

Long Name 1: GEAUGA COUNTY SHERIFFS OFFICE
Long Name 2:

Address 1: 12450 MERRITT ROAD
Address 2:

City: CHARDON
Zip Code: 44024
County: GEAU

Contact: CHUCK NEGRON
Title:
Phone: 4402864031
FAX: 4402863251

Vendor: 3144

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012