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APPENDIX:Primarycareproviderswithatleastoneclaim,July1,2017June30,2018 1 ByProvidertype ProviderType DROFOSTEOPATHMED(INDIGO) PHYSICIAN(INDIGO) PRESCRIBINGONLYPROVIDER SCHOOLBSEDHEALTHCTR(INST) SUBS/ALCOHABSECTR(COVERS)
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Appendix II is a specific form required by the Local Department of Health and Licensing Administration (LDHLA) that is used for reporting various compliance and regulatory details.
Entities and individuals that fall under certain regulatory categories set by LDHLA are required to file Appendix II.
To fill out Appendix II, individuals must provide specific information as outlined in the instructions provided by LDHLA, ensuring that all required sections are completed accurately.
The purpose of Appendix II is to collect necessary data to ensure compliance with health and safety regulations, and to maintain public health standards.
Information that must be reported includes facility details, compliance history, operational practices, and any other relevant data as required by LDHLA.
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