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PRINTED: 09/11/2013 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER: (X3) DATE SURVEY COMPLETED 03/21/2013

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What is identification number?

An identification number is a unique code assigned to an individual or entity for identification purposes.

Who is required to file identification number?

Individuals or entities who need to be identified for legal or regulatory purposes are required to file an identification number.

How to fill out identification number?

Identification numbers can be filled out by providing the necessary information requested on the form or application.

What is the purpose of identification number?

The purpose of an identification number is to uniquely identify individuals or entities for tracking and regulatory purposes.

What information must be reported on identification number?

The information reported on an identification number may include personal or business details, depending on the context.

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