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Humana Military Eia Supervisor Application Form

Humana Military Eia Supervisor Application Form

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Information. Ensure all blocks are completed. Section B – Qualification as EIA Supervisor • You must include a copy of your Certification(s) Section C – General Practice Information Ensure all blocks are completed. If any blocks do not apply to you, please mark the block with “N/A”. Section D – Correspondence Address / Billing Address. Ensure all blocks are completed Section E – NPI Information • The National Provider Identifier (NPI) is a unique 10-digit numeric identifier assigned to...
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