MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 8346
Change Report (if Any):

Short Name: BIG BR/SIS-LUCA

Long Name 1: BIG BROTHERS BIG SISTERS OF
Long Name 2: NORTHWESTERN OHIO

Address 1: FOUR SEAGATE SUITE 660
Address 2:

City: TOLEDO
Zip Code: 43604
County: LUCA

Contact: BARBIE HARRISON
Title: CEO
Phone: 4192434600
FAX: 4192432402

Vendor: 8346

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 06/28/2012

File Produced: 14JUL2016