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3RDPARTYCOMPUTERACCESSREQUEST REQUESTOR: CompleteandFaxtoVHSInformationServices(702)8538953. PleasePRINTallinformation. RequestorLastNameFirstNameInitialRequestorContactPhone#**YoumustentereitheraFAXnumberoranEmailinordertoreceiveyourloginID**
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01
Begin by gathering all necessary information about the physician practice such as their name, contact details, and address.
02
Determine the legal structure of the physician practice, whether it is a corporation, partnership, or sole proprietorship.
03
Fill out the necessary information about the physician practice's ownership, including the names and roles of each owner.
04
Provide information about the services offered by the physician practice, such as the medical specialties they focus on.
05
Include details about any affiliations or partnerships the physician practice has with other healthcare organizations.
06
Fill out information about the operating hours and appointment scheduling process of the physician practice.
07
Provide any additional details or disclosures required by the form, such as financial information or compliance with healthcare regulations.
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Review the completed form for accuracy and make any necessary revisions.
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Submit the filled-out nameofgroupcompanyphysicianpractice form as per the specified instructions.

Who needs nameofgroupcompanyphysicianpractice?

01
Medical professionals or healthcare organizations who are establishing or updating the records of a physician practice.
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Government agencies or regulatory bodies involved in healthcare oversight and monitoring.
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Researchers or analysts conducting studies or market research on physician practices.
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Anyone seeking to understand the structure and operations of a specific physician practice.
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Name of Group Company Physician Practice refers to the official title of a medical practice or organization that employs multiple physicians working together.
Physician practices that operate as a collective entity, such as groups of doctors or medical organizations, are required to file the Name of Group Company Physician Practice.
To fill out the Name of Group Company Physician Practice, you need to provide the official name, relevant details of each physician, the practice's federal tax ID number, and any other required documentation as specified by regulatory authorities.
The purpose of the Name of Group Company Physician Practice is to formalize the structure of the practice for regulatory compliance, tax reporting, and to facilitate billing and insurance processing.
Information that must be reported includes the legal name of the practice, names of the physicians involved, their specialties, location, federal tax ID number, and contact information.
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