UPI (Provider ID): 11201
Change Report (if Any):

Short Name: BEACON-MAUMEE

Long Name 1: BEACON AGENCY INC
Long Name 2:

Address 1: 1718 INDIAN WOOD CIRCLE
Address 2: SUITE A

City: MAUMEE
Zip Code: 43537
County: LUCA

Contact: JOAN DAUGNEAUX
Title:
Phone: 4198871629
FAX: 4198871636

Vendor: 10483

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016