Enrollment and Revalidation Checklist
May 17, 2018 · ☐Provider Profit Status (examples include, but are not limited to, for-profit or non-profit) ☐Provider Corporation Type (examples include, but are not limited to, proprietary-individual, or government-hospital) ☐If the Pay-To provider is a Public Provider under the Code of Federal Regulations – Title 42:Public Health ................
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