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PRINTED: 11/02/2021
FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES
CENTERS FOR MEDICARE & MEDICAID SERVICES
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA
IDENTIFICATION
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How to fill out provider number 155572
How to fill out provider number 155572
01
Contact the appropriate licensing or certifying organization to obtain the necessary application forms.
02
Fill out all required sections of the application form, including personal information, contact details, and any relevant qualifications or experience.
03
Make sure to include the correct provider number 155572 on the application form where required.
04
Double check all the information provided for accuracy before submitting the application.
05
Submit the completed application form along with any required supporting documents to the licensing or certifying organization.
Who needs provider number 155572?
01
Healthcare providers, such as doctors, nurses, therapists, and other medical professionals, who are seeking certification or licensure in a specific field may need provider number 155572.
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What is provider number 155572?
Provider number 155572 is a unique identifier assigned to a healthcare provider.
Who is required to file provider number 155572?
Healthcare providers who are registered and authorized in the system are required to file provider number 155572.
How to fill out provider number 155572?
Provider number 155572 can be filled out by logging into the designated portal and entering the required information accurately.
What is the purpose of provider number 155572?
The purpose of provider number 155572 is to track and identify healthcare providers for billing and administrative purposes.
What information must be reported on provider number 155572?
Provider number 155572 requires the reporting of basic information such as the provider's name, contact details, specialty, and billing information.
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