UPI (Provider ID): 7065
Change Report (if Any):

Short Name: CATH SOC-SIDNEY

Long Name 1: CATHOLIC SOCIAL SERVICES
Long Name 2: OF THE MIAMI VALLEY

Address 1: 1201 FAIRINGTON DRIVE
Address 2:

City: SIDNEY
Zip Code: 45365
County: SHEL

Contact: JEAN DUGAN
Title:
Phone: 9374984593
FAX: 9374930269

Vendor: 7065

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/17/2012

File Produced: 19MAY2012