Missouri Medicaid Audit & Compliance » MMAC

Attach a copy of the Federal Tax ID number notification from the IRS that includes the new EIN number. Attach a MO OA Vendor Input/ACH-EFT Application and DSS-MMAC EFT Form ADDRESS FOR MAIN OFFICE _____ Check all that this change applies to: Physical* Mailing Pay To/IRS Documents. Attach a MO OA Vendor Input/ACH-EFT form listing your new address: ................
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