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Get the free NPI Information Form - Fax Cover Sheet - 2/6/07

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FAX COVER SHEET NPI Information Form Date: To: Page 1 of pages Provider Information Unit Fax: (808) 9486887 HSA Provider Relations Phone (808) 9485190 From: Phone: Fax: NPI Information Form and supporting
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Read and understand the instructions on the NPI information form.
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Gather all the necessary information and documents required to fill out the form.
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Fill out the form accurately and legibly, providing the required information in each section.
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Who needs npi information form?

01
Healthcare providers who are eligible for National Provider Identifier (NPI) registration need the NPI information form.
02
Individuals or entities who are categorized as healthcare providers, such as physicians, dentists, hospitals, clinics, pharmacies, etc., require the NPI information form.
03
Organizations or individuals who bill for healthcare services or submit healthcare claims also need to fill out the NPI information form.
04
Any healthcare provider who wants to obtain or update their NPI number should complete the NPI information form.
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The NPI information form is a document used to collect details about a National Provider Identifier (NPI) for healthcare providers.
Healthcare providers, including individuals and organizations, are required to file the NPI information form.
The NPI information form can be filled out online or through paper forms provided by the NPI Enumerator.
The purpose of the NPI information form is to assign and manage unique NPI numbers to healthcare providers, facilitating billing and identification purposes.
The NPI information form requires details such as provider name, address, contact information, specialty, and other relevant information for identification purposes.
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