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ELECTRONIC DATA INTERCHANGE (EDI) ENROLLMENT41210All fields marked with * are required and must be completed. Reference Materials are available on the last page of this document. Apart A (Institutional) Part
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This could include healthcare providers, medical practitioners, clinics, hospitals, or any entity involved in the provision of medical services.
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C practice location is the physical address where a business conducts its operations or provides services.
Businesses that operate in a specific location are required to file c practice location.
You can fill out c practice location by providing the address where your business operates.
The purpose of c practice location is to ensure that businesses can be located and contacted at their primary place of operations.
The information that must be reported on c practice location includes the street address, city, state, and zip code of the business location.
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