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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:15541204/11/2017FORM

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How to fill out provider number 155412

01

To fill out provider number 155412, you need to follow these steps:

02

Start by gathering all the necessary information and documents.

03

Open the provider registration form.

04

Fill in your personal details such as your name, address, and contact information.

05

Locate the field for provider number and enter '155412' in the appropriate box.

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Once you are certain everything is filled out correctly, submit the form.

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Wait for confirmation of your provider number via email or mail.

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Keep a record of your provider number for future reference.

Who needs provider number 155412?

01

Provider number 155412 is needed by individuals or organizations who wish to become registered providers within a specific system or network. This number helps identify and distinguish them from other providers in the system.

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What is provider number 155412?

Provider number 155412 is a unique identification number assigned to healthcare providers for billing and reporting purposes.

Who is required to file provider number 155412?

Healthcare providers who deliver specific services and wish to be reimbursed by insurance or government programs are required to file provider number 155412.

How to fill out provider number 155412?

To fill out provider number 155412, provide accurate identification and demographic information, as well as details of services offered and any necessary certifications.

What is the purpose of provider number 155412?

The purpose of provider number 155412 is to facilitate the billing process and ensure accurate tracking of services provided by healthcare professionals.

What information must be reported on provider number 155412?

Information that must be reported includes provider identification details, service descriptions, reimbursement requests, and relevant certifications.

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