MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 10297
Change Report (if Any):

Short Name: SHERIFF-MERCER

Long Name 1: MERCER COUNTY SHERIFFS OFFICE
Long Name 2:

Address 1: 125 WEST LIVINGSTON STREET
Address 2:

City: CELINA
Zip Code: 45822
County: MERC

Contact: JEFF GREY
Title: SHERF
Phone: 4195867724
FAX: .

Vendor: 10297

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016