MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 8020
Change Report (if Any):

Short Name: YWCA - FRANKLIN

Long Name 1: YWCA
Long Name 2:

Address 1: 65 SOUTH FOURTH STREET
Address 2:

City: COLUMBUS
Zip Code: 43215
County: FRAN

Contact: KATHY LANSBERRY
Title: CFO
Phone: 6142249121
FAX: 6142242522

Vendor: 8020

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012