MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 6691
Change Report (if Any):

Short Name: IKRON

Long Name 1: IKRON CORPORATION
Long Name 2:

Address 1: 2347 VINE STREET
Address 2:

City: CINCINNATI
Zip Code: 45219
County: HAMI

Contact: DAVID JAMES
Title:
Phone: 5136211117
FAX: 5136212350

Vendor: 6691

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/05/2012

File Produced: 19MAY2012