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PROVIDER CCN: 140281 NORTHWESTERN MEMORIAL HOSPITAL PERIOD FROM 09×01/2012 TO 08×31/2013 KPMG LLP COMPLEX MICRO SYSTEM IN LIEU OF FORM CMS255210 (08×2011) VERSION: 2013.11 01×30/2014 14:32 HOSPITAL
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01
Make sure you have all the necessary information and documentation needed to complete the form.
02
Begin by entering your name and contact information accurately in the designated fields.
03
Next, provide your provider identification number and any relevant licensing information.
04
Fill out the sections regarding your practice or facility, including the name, address, and contact details.
05
Indicate the type of services you offer and specify any specialties or sub-specialties.
06
Provide accurate information about the date and location of your practice or facility.
07
Complete the sections related to your billing information, such as the tax identification number and payment preferences.
08
If required, provide additional documentation or attachments to support your application.
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Once you have double-checked all the information, sign and date the form.
Who needs provider ccn 14-0281 northwestern?
01
Healthcare providers or facilities affiliated with or associated with Northwestern Medical Center.
02
Individuals or organizations seeking to establish a professional relationship with Northwestern Medical Center.
03
Providers looking to access certain resources, services, or benefits offered exclusively to providers associated with Northwestern Medical Center.
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What is provider ccn 14-0281 northwestern?
Provider CCN 14-0281 Northwestern is a unique identification code assigned to a healthcare provider located in the Northwestern region.
Who is required to file provider ccn 14-0281 northwestern?
All healthcare providers operating in the Northwestern region and holding CCN 14-0281 are required to file.
How to fill out provider ccn 14-0281 northwestern?
To fill out Provider CCN 14-0281 Northwestern, the required information must be accurately provided in the designated fields.
What is the purpose of provider ccn 14-0281 northwestern?
The purpose of Provider CCN 14-0281 Northwestern is to uniquely identify and track healthcare providers in the Northwestern region.
What information must be reported on provider ccn 14-0281 northwestern?
Provider CCN 14-0281 Northwestern may require reporting of provider details, services offered, and other relevant information.
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