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PROVIDER CCN: 140167 IROQUOIS MEMORIAL HOSPITAL PERIOD FROM 10/01/2011 TO 09/30/2012OPTIMIZER SYSTEMS, INC. WHIPLASH MICRO SYSTEM IN LIEU OF FORM CMS255210 (08/2011)HOSPITAL AND HOSPITAL HEALTH CARE
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Open your web browser and go to www.medicarelist.com
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Search for 'Iroquois Memorial Hospital' in the search bar at the top of the page.
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Click on the search result that matches Iroquois Memorial Hospital.
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In the hospital's profile page, you will find a form to fill out.
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Fill out the form by providing the required information, such as your name, contact details, insurance information, and any specific medical conditions or requirements.
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Once you have filled out the form completely, submit it by clicking on the 'Submit' or 'Send' button.
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You have successfully filled out the form on www.medicarelist.com to request services from Iroquois Memorial Hospital.

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