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PRINTED: 07/08/2024
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 155767
How to fill out provider number 155767
01
Obtain the necessary forms from the appropriate regulatory body.
02
Fill in the required personal and professional information such as name, address, and qualifications.
03
Provide details specific to provider number 155767, including any relevant documentation.
04
Review the filled-out application for accuracy.
05
Submit the application via the designated method (online, mail, in-person).
06
Wait for confirmation and any additional instructions from the regulatory body.
Who needs provider number 155767?
01
Healthcare professionals seeking to practice and bill for services.
02
Providers who need to be enrolled in a health insurance program.
03
Organizations or facilities requiring a unique identification number for reimbursement purposes.
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What is provider number 155767?
Provider number 155767 is a unique identification number assigned to a healthcare provider for billing and credentialing purposes.
Who is required to file provider number 155767?
Healthcare providers, including physicians, clinics, and hospitals, who wish to receive reimbursements from insurance companies or government programs are required to file provider number 155767.
How to fill out provider number 155767?
To fill out provider number 155767, follow the specific guidelines provided by the billing authority, ensuring accurate completion of personal, practice, and financial information.
What is the purpose of provider number 155767?
The purpose of provider number 155767 is to enable providers to bill for services rendered, facilitating reimbursement and tracking of healthcare services.
What information must be reported on provider number 155767?
Information required on provider number 155767 typically includes provider identification, practice location, specialty, Tax Identification Number (TIN), and contact information.
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