MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 3444
Change Report (if Any):

Short Name: NB NORTHCOAST

Long Name 1: NB NORTHCOAST SERVICES
Long Name 2:

Address 1: 1756 SAGAMORE ROAD
Address 2:

City: NORTHFIELD
Zip Code: 44067
County: SUMM

Contact: ROBERT DUNS
Title:
Phone: 3304677131
FAX: 3304674028

Vendor: 3275

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016