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Other Eligible Entity Attestation
National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: 45 CFR Part 60 Regulations and Forms
OMB: 0915-0126
IC ID: 245415
OMB.report
HHS/HSA
OMB 0915-0126
ICR 202310-0915-003
IC 245415
( )
Documents and Forms
Document Name
Document Type
Form 44
Other Eligible Entity Attestation
Form and Instruction
44 Other Eligible Entity Attestation.pdf
Other Eligible Entity Attestation.pdf
Form and Instruction
Information Collection (IC) Details
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