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Attention: Provider Services 910 Douglas Pike Smithfield, RI 02917 Phone: 14014596020 or 18004596019 Fax: 14017097066New Practitioner Education Form Please complete this form and return via fax or
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18004596019 is a form used for reporting certain information to the IRS.
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The purpose of 18004596019 is to provide the IRS with information about certain financial activities.
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