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30 <br />Attachment 2 <br />Participant Staff Contact Information <br />Please provide contact information for the following staff members at your organization. Each field must be filled <br />even if one person occupies more than one role. All fields must be completed or the processing of <br />your Participation Agreement will be delayed. <br />Participant Account Administrator <br />Staff member who will be the point of contact for the NC HIEA for communications and credentialing <br />NC HealthConnex users in your organization. <br />Name: <br />Position Title: <br />Email Address: <br />Phone Number: <br />Mailing Address: <br />Technical Services Contact <br />Staff member who will work with our technology vendor to build a connection from your organization to <br />NC HealthConnex. <br />Name: <br />Position Title: <br />Email Address: <br />Phone Number: <br />Mailing Address: <br />Kyle Ronn <br />Quality Assurance Coordinator <br />kronn@orangecountync.gov <br />(919)245-6124 <br />510 Meadowlands Drive, Hillsborough, NC 27278 <br />Beth Ann Arbogast <br />IT Systems Analyst <br />barbogast@orangecountync.gov <br />(919)245-2282 <br />131 West Margaret Lane, Hillsborough, NC 27278 <br />DocuSign Envelope ID: 47B4445A-C7CA-4D2E-9075-2AFD82F82DEC