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Please mail or fax to: Eden 220 Burnham St., South Windsor, CT 06074 Phone: 8882557293 Fax: 8602890055 Registration Form Please type or print. Practice Name: Contact Name: Address: Suite: City: State:
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What is provider 2 provider 3?
Provider 2 provider 3 refers to the process of one service provider transferring specific information or services to another service provider.
Who is required to file provider 2 provider 3?
The service providers involved in the transfer of information or services are required to file provider 2 provider 3.
How to fill out provider 2 provider 3?
Provider 2 provider 3 is typically filled out by providing detailed information about the transferred services or information, including the sender and recipient details.
What is the purpose of provider 2 provider 3?
The purpose of provider 2 provider 3 is to ensure that the transfer of services or information between service providers is properly documented and accounted for.
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Information such as the nature of services transferred, the date of transfer, sender and recipient details, and any relevant identifiers must be reported on provider 2 provider 3.
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