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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15G09210/24/2016FORM
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Provider number 15g092 is a unique identification number assigned to a specific service provider.
Service providers who have received payments or income are required to file provider number 15g092.
Provider number 15g092 can be filled out by entering the required information such as name, address, services provided, and payment received.
The purpose of provider number 15g092 is to track and record payments made to service providers for tax reporting purposes.
Information such as name of service provider, address, services provided, and total payment received must be reported on provider number 15g092.
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