MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 8468
Change Report (if Any):

Short Name: PHILIO INC

Long Name 1: PHILIO INCORPORATED
Long Name 2:

Address 1: 5301 NEBRASKA AVENUE
Address 2:

City: TOLEDO
Zip Code: 43615
County: LUCA

Contact: JANICE EDWARDS
Title: EXDIR
Phone: 4195315544
FAX: 4195315117

Vendor: 8468

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/28/2011

File Produced: 19MAY2012