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NPI: 1245236306INFLUENZA VACCINE 20182019 HEALTH SCREEN & PERMISSION FORM Full Name:Date of Birth:Street Address:/ / Town/City:Grade:Age:Gender: M Zip Code:Teacher:School Name: F Daytime Phone:School
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What is mainecare id?
Mainecare ID is a unique identifier assigned to individuals who are enrolled in the Maine Medicaid program.
Who is required to file mainecare id?
Mainecare ID is required to be filed by individuals who are seeking Medicaid benefits in the state of Maine.
How to fill out mainecare id?
Mainecare ID can be filled out online through the Maine Medicaid website or by contacting the local Medicaid office for assistance.
What is the purpose of mainecare id?
The purpose of mainecare ID is to accurately identify individuals who are eligible for Medicaid benefits and ensure they receive the appropriate services.
What information must be reported on mainecare id?
Mainecare ID requires personal information such as name, address, date of birth, and income to determine eligibility for Medicaid benefits.
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