UPI (Provider ID): 8184
Change Report (if Any):

Short Name: TASC OF SE ATHE

Long Name 1: TASC OF SOUTHEAST OHIO
Long Name 2:

Address 1: 8 NORTH COURT STREET FL 5
Address 2:

City: ATHENS
Zip Code: 45701
County: ATHE

Contact: AMY SEE
Title: MIS
Phone: 7405942276
FAX: 7405943105

Vendor: 8184

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 03/06/2012

File Produced: 19MAY2012