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PRINTED 07/08/2009 FORM APPROVED California Department of Public Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION X 1 PROVIDER/SUPPlIER/ClIA X3 DATE SURVEY COMPLETED X2 MUL TIPLE CONSTRUCTION IDENTIFICA TlON NUMBER A BUILDING B WlNG C 10/21/2008 250000507 STREET ADDRESS CITY. 9 At the cOnclusion of the case before the for initialing atl surgical counts lies with- the 5urg n leaves thl room the clroulator and -scrub tech wui reoooclle all fnstrtJments of tfle I partlcfpatiAg In the...
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What is x 1 providersupplierclia?
x 1 providersupplierclia is a unique identification number assigned to healthcare providers and suppliers by the Center for Medicare and Medicaid Services (CMS).
Who is required to file x 1 providersupplierclia?
Healthcare providers and suppliers who want to bill Medicare for services rendered are required to file for x 1 providersupplierclia.
How to fill out x 1 providersupplierclia?
To fill out x 1 providersupplierclia, healthcare providers and suppliers must submit an application to CMS with required documentation and information.
What is the purpose of x 1 providersupplierclia?
The purpose of x 1 providersupplierclia is to uniquely identify healthcare providers and suppliers for billing and tracking purposes.
What information must be reported on x 1 providersupplierclia?
Information such as business name, address, contact information, and type of services provided must be reported on x 1 providersupplierclia.
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