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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES12/05/2011FORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 09380391STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION

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What is e 0039?

E 0039 is a form used for reporting certain information to the IRS.

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E 0039 requires reporting of specific financial information as outlined by the IRS.

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