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Fax: (844) 424-3976. Phone: (602) 586-1841 (800) 564-5465. DME Prior Authorization Standard Request Form. Provider Fax Number: Date of Request:
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The fax number 844-424-3976 is used for filing specific documents or forms.
Individuals or entities designated by the relevant authority may be required to file documents or forms to the fax number 844-424-3976.
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