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1.00PRINTED: 5/5/2017DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDHEALTH CARE FINANCING ADMINISTRATION STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (POC)2567L(XI) PROVIDER/SUPPLIER/CIA
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Identifying information is personal data that distinguishes one individual from another, such as name, address, date of birth, and Social Security number.
Individuals and entities that are obligated to provide personal information in order to comply with certain regulations or laws.
Identifying information can be filled out on official forms provided by the relevant authorities, online portals, or through designated representatives.
The purpose of identifying information is to accurately identify and verify individuals for legal, regulatory, or security purposes.
Information such as full name, address, date of birth, and Social Security number may need to be reported on identifying information forms.
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