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SD/MC PROVIDER CERTIFICATION & RECERTIFICATION PROTOCOL Department of Health Care Services (DOCS) *Revised June 2014×COUNTY:DATE:PROVIDER NUMBER:NPI #:DAYS/HOURS OF OPERATION:PROVIDER NAME: ADDRESS:
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How to fill out dayshours of operation
01
Start by determining the days and hours your business operates.
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04
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Consider any special days or holidays when your business may have altered operating hours, and make note of them.
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