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PHARMACYSERVICES UniformMedicalPlan Pre-authorization(PA)Requestor PHONE(888)3611611 FAX(800)2078235 DATE: SENDERSINITIALS: PATIENTINFORMATION ENROLLEENAME: SUBSCRIBER ID#: DATEOFBIRTH: PHYSICIANINFORMATION
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The 44884817 tel form is a tax form used to report telecommunications excise taxes.
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The purpose of the 44884817 tel form is to report and pay telecommunications excise taxes.
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