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Purdue University Northwest Benefits IneligibleClient/Ins: 2635 Ward: PUB ***PLEASE PRINT LEGIBLY***Doctor: WORK Tax ID: 351835133NPI: 1689746000Name (Print)___ FirstLastAddress___BP ___/_ ___City___State___Zip___
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Limited duration customer service is a temporary customer service provided for a specific period of time.
Any business or organization that offers temporary customer service is required to file limited duration customer service.
Limited duration customer service can be filled out by providing details about the temporary service being offered and the period of time it will be available.
The purpose of limited duration customer service is to track and monitor temporary customer service offerings to ensure compliance with regulations.
Information such as the type of temporary service, duration, location, and contact information must be reported on limited duration customer service.
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