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06/28/2018PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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Facility number 012547 is a unique identifier given to a specific facility by the regulatory agency.
The owner or operator of the facility is required to file facility number 012547.
Facility number 012547 should be filled out by providing all the requested information accurately.
The purpose of facility number 012547 is to track and monitor a specific facility's compliance with regulations.
Information such as facility location, contact information, type of operations, and potential hazards must be reported on facility number 012547.
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