UPI (Provider ID): 8321
Change Report (if Any):

Short Name: STARK TASC

Long Name 1: STARK COUNTY TASC
Long Name 2:

Address 1: 1375 RAFF ROAD SW
Address 2:

City: CANTON
Zip Code: 44710
County: STAR

Contact: Patty Eneix
Title:
Phone: 3304791912
FAX: 3304791916

Vendor: 8321

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/21/2011

File Produced: 19MAY2012