Insurance license lookup california
Application for Licensure to Provide Substance Abuse Services
A late fee of $100 per license component shall be assessed for the late filing of an application as required under Section 397.407(2) Florida Statutes. Applications for renewal submitted less than 60 days, but at least 30 days before the license expires, will be processed and late fees will be applied.
[DOC File]A GUIDE TO PRESCRIBING, ADMINISTERING AND DISPENSING
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The hospital must assign a special suffix to the hospital DEA number to identify these physicians. Physicians in residency are limited by their limited license to treating patients of the hospital in which they are practicing. Associate veterinarians working for an employer who has a DEA number.
[DOC File]VERIFICATION OF SOCIAL SECURITY NUMBERS
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A driver’s license. Identification card issued by a federal, state, or local agency. Identification card issued by a medical insurance company or provider (including Medicare and Medicaid). Identification card issued by an employer or trade union. Benefit award letters from government agencies. Retirement benefit letter. Life insurance policies
[DOC File]Code - New Jersey
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id no name of insurance company address address address city st zip notes 001 samsung fire and marine insurance company, ltd. 25 challenger road ridgefield park nj 07660 comm only 002 brotherhood mutual insurance company po box 2227 fort wayne in 46801 comm only 003 mid-century ins company 4680 wilshire blvd los angeles ca 90010 priv pass and comm 004 ace property & casualty ins co 1601 ...
[DOC File]ACORD™ CERTIFICATE OF LIABILITY INSURANCE
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The Certificate of Insurance on the reverse side of this form does not constitute a contact between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) INSR. LTR.
[DOC File]Implementation Guide forImmunization Data Transactions ...
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Insurance (IN1) Segment. 58. 6.4.7. Insurance Additional Information (IN2) Segment. 58. ... patient 20 25 DLN O 00123 Driver’s license number - patient 21 20 CX O Y 00124 Mother’s identifier 22 80 CE O Y 0189 00125 Ethnic group 23 60 ST O 00126 Birth place 24 1 ID O 0136 00127 Multiple birth indicator 25 2 NM O 00128 Birth order 26 80 CE O ...
[DOC File]Collaborative and Prescriptive Authority Agreement
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Sterling Area Health Center . Nurse Practitioner/Physician Assistant. Collaborative and Prescriptive Authority Agreement. The undersigned licensed Physician Assistant or Nurse Practitioner and Physician(s) agree to the following collaborative practice agreement for provision of health care services at the Sterling Area Health Center.
[DOCX File]Chapter 3 - Military Assistance Program Address Directory ...
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C3.1.1. Purpose. This chapter establishes information requirements for the Military Assistance Program Address Directory (MAPAD). This chapter prescribes the standards to establish, maintain, publish, and disseminate address data to requiring Military Service organizations, Federal agencies, foreign country representatives, freight forwarders, and commercial firms under DoD contracts who are ...
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