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PROVIDER CCN: 140239 ROCKFORD MEMORIAL HOSPITAL PERIOD FROM 01/01/2011 TO 12/31/2011KPMG LLP COMPLEX MICRO SYSTEM IN LIEU OF FORM CMS255210 (08/2011)VERSION: 2011.10 05/24/2012 14:18HOSPITAL AND HOSPITAL
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How to fill out provider ccn 14-0239
How to fill out provider ccn 14-0239
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To fill out provider ccn 14-0239, follow these steps:
02
Start by entering the required provider information such as name, address, and contact details.
03
Next, provide details about the services or products you offer as a provider.
04
Include any certifications or licenses you hold that are relevant to your profession.
05
Ensure you accurately fill out the financial information section, including your billing and payment details.
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It is essential to thoroughly review the form for any errors or missing information before submitting it.
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Finally, submit the filled-out provider ccn 14-0239 form according to the specified instructions.
Who needs provider ccn 14-0239?
01
Provider ccn 14-0239 is required by healthcare professionals or providers who wish to become certified providers or participate in certain medical programs.
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What is provider ccn 14-0239?
Provider ccn 14-0239 is a unique identification number assigned to a healthcare provider or facility by the Centers for Medicare & Medicaid Services (CMS).
Who is required to file provider ccn 14-0239?
All Medicare participating providers and suppliers are required to have and report a provider ccn 14-0239.
How to fill out provider ccn 14-0239?
Provider ccn 14-0239 can typically be filled out on Medicare enrollment applications or revalidation forms.
What is the purpose of provider ccn 14-0239?
The purpose of provider ccn 14-0239 is to uniquely identify healthcare providers and facilities that participate in the Medicare program.
What information must be reported on provider ccn 14-0239?
Provider ccn 14-0239 typically includes information such as the provider's name, address, type of facility, and other identifying details.
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