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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESPOSTCERTIFICATION REVISIT REPORT PROVIDER / SUPPLIER / CIA / IDENTIFICATION NUMBER345384Y1MULTIPLE CONSTRUCTION A. Building

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Obtain the 80b1-4 form from the appropriate agency or organization.

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What is 80b1-4?

80b1-4 refers to a specific form used for reporting certain information to the appropriate authorities.

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Entities or individuals specified by the governing body are required to file 80b1-4.

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To fill out 80b1-4, one must provide the required information accurately and completely as per the guidelines provided.

What is the purpose of 80b1-4?

The purpose of 80b1-4 is to gather specific information for regulatory or compliance purposes.

What information must be reported on 80b1-4?

Information such as financial data, ownership details, and other relevant information as per the regulations must be reported on 80b1-4.

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