Payer's Request For Identifying Number Of Supplier Or Provider Of Medical And Health Care Services

OMB 1545-0178

Latest Forms, Documents, and Supporting Material

Document Name
PAYER'S REQUEST FOR IDENTIFYING NUMBER OF SUPPLIER OR PROVIDER OF MEDICAL AND HEALTH CARE SERVICES Form

All Historical Document Collections

198304-1545-005 Approved without change	Extension without change of a currently approved collection	1983-04-08
198107-1545-038 Approved without change	Revision of a currently approved collection	1981-07-30
198104-1545-178 Approved without change	Revision of a currently approved collection	1981-04-01