Form preview

Get the free Provider number: 155290

Get Form
12/27/2019PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign provider number 155290

Edit
Edit your provider number 155290 form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your provider number 155290 form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing provider number 155290 online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Here are the steps you need to follow to get started with our professional PDF editor:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit provider number 155290. Rearrange and rotate pages, insert new and alter existing texts, add new objects, and take advantage of other helpful tools. Click Done to apply changes and return to your Dashboard. Go to the Documents tab to access merging, splitting, locking, or unlocking functions.
4
Save your file. Select it from your records list. Then, click the right toolbar and select one of the various exporting options: save in numerous formats, download as PDF, email, or cloud.
It's easier to work with documents with pdfFiller than you can have believed. You can sign up for an account to see for yourself.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out provider number 155290

Illustration

How to fill out provider number 155290

01
To fill out provider number 155290, follow these steps:
02
Locate the required form or document that requires the provider number.
03
Look for the field or section where the provider number is requested.
04
Enter the number 155290 into the designated field or section.
05
Double-check the entered number to ensure accuracy.
06
Save or submit the form/document as required.

Who needs provider number 155290?

01
Anyone who is associated with or requires services from provider number 155290 needs it. This could include clients or customers who need to identify the specific provider, organizations that use the provider number for record keeping or reimbursement purposes, and regulatory agencies that monitor and track provider information.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.6
Satisfied
50 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

With pdfFiller, an all-in-one online tool for professional document management, it's easy to fill out documents. Over 25 million fillable forms are available on our website, and you can find the provider number 155290 in a matter of seconds. Open it right away and start making it your own with help from advanced editing tools.
Yes. With pdfFiller for Chrome, you can eSign documents and utilize the PDF editor all in one spot. Create a legally enforceable eSignature by sketching, typing, or uploading a handwritten signature image. You may eSign your provider number 155290 in seconds.
Upload, type, or draw a signature in Gmail with the help of pdfFiller’s add-on. pdfFiller enables you to eSign your provider number 155290 and other documents right in your inbox. Register your account in order to save signed documents and your personal signatures.
Provider number 155290 is a unique identification number assigned to a healthcare provider.
Healthcare providers who offer services or supplies reimbursable under a government healthcare program are required to file provider number 155290.
Provider number 155290 can be filled out by submitting the required information online through the designated healthcare program portal.
The purpose of provider number 155290 is to track and verify healthcare services provided by healthcare providers for reimbursement purposes.
Provider number 155290 requires healthcare providers to report details such as services provided, patient information, and billing codes.
Fill out your provider number 155290 online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.