340B Drug Pricing Program Database


DSH500064AB HARBORVIEW MEDICAL CENTER (Active) - information as of 5/24/2025 10:37:01 PM

Main Details
HARBORVIEW MEDICAL CENTER
Vascular Lab
Disproportionate Share Hospital
No
DSH500064AB
500064


Additional Details
Active
10/30/2014
1/1/2015
11/5/2014
8/28/2024

Contacts

UW Medicine
Jacqueline L Cabe, Chief Financial Officer
(206) 616-9886

UW Medicine
Sumona Patel, Pharmacy Audit and Compliance Manager
(206) 598-6936

Addresses

908 Jefferson St
Seattle, WA 98104-2499

UW Medicine
PO BOX 45404
Seattle, WA 98145


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
AK 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
CA 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
ID 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
KY 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
MT 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
NJ 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
NY 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
OH 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
OR 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
WA 1053359729,1083121545,1154712636,1235777616,1710102264,1750647707,1861030249,1659027985,1710684469
MO 1053359729,1710102264,1154712636,1861030249,1750647707,1083121545,1235777616,1659027985,1710684469
OK 1053359729,1710102264,1154712636,1861030249,1750647707,1083121545,1235777616,1659027985,1710684469
Shipping Addresses

Same as Street Address
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH500064AChildDSHHARBORVIEW MEDICAL CENTERPioneer Sq Neighborhood Clinic206 3rd Avenue SouthSeattleWAActive
DSH500064AAChildDSHHARBORVIEW MEDICAL CENTERSpecialty Clinics 7MB410 9th AvenueSeattleWATerminated
DSH500064ABChildDSHHARBORVIEW MEDICAL CENTERVascular Lab908 Jefferson StSeattleWAActive
DSH500064ACChildDSHHARBORVIEW MEDICAL CENTERSleep Disorders401 BroadwaySeattleWAActive
DSH500064ADChildDSHHARBORVIEW MEDICAL CENTERHMHS PSYCHOTHERAPY CLINIC401 BroadwaySeattleWAActive
DSH500064AEChildDSHHARBORVIEW MEDICAL CENTERHMHS Gero Psych Clinic401 BroadwaySeattleWAActive
DSH500064AFChildDSHHARBORVIEW MEDICAL CENTERRehab Medicine Clinic908 Jefferson StSeattleWAActive
DSH500064AGChildDSHHARBORVIEW MEDICAL CENTERAcute PT/OT/Speech410 9th AvenueSeattleWATerminated
DSH500064AHChildDSHHARBORVIEW MEDICAL CENTERRehab OP Ortho OT PT908 Jefferson StSeattleWAActive
DSH500064AJChildDSHHARBORVIEW MEDICAL CENTEREar Nose Throat Clinic908 JeffersonSeattleWATerminated
DSH500064AKChildDSHHARBORVIEW MEDICAL CENTERHMC Prosthetic & Orthotic Service501 Eastlake Ave E.SeattleWAActive
DSH500064ALChildDSHHARBORVIEW MEDICAL CENTERHCSAT Medicine Clinic401 BroadwaySeattleWATerminated
DSH500064AMChildDSHHARBORVIEW MEDICAL CENTERHCSAT Medicine Clinic401 BroadwaySeattleWAActive
DSH500064ANChildDSHHARBORVIEW MEDICAL CENTERAmbulatory Proc Spec Unit410 9th AvenueSeattleWAActive
DSH500064APChildDSHHARBORVIEW MEDICAL CENTERHCSAT Counseling Cln401 BroadwaySeattleWAActive
DSH500064AQChildDSHHARBORVIEW MEDICAL CENTERChildren's Response Center1401 E. JeffersonSeattleWATerminated
DSH500064ARChildDSHHARBORVIEW MEDICAL CENTERComp OP Rehab Clinic908 Jefferson StSeattleWAActive
DSH500064ASChildDSHHARBORVIEW MEDICAL CENTERNeurosciences Clinic908 Jefferson StSeattleWAActive
DSH500064ATChildDSHHARBORVIEW MEDICAL CENTERSleep Medicine Clinic401 Broadway St.SeattleWAActive
DSH500064AUChildDSHHARBORVIEW MEDICAL CENTERNORM MALE - Neurology Clinic908 Jefferson StSEATTLEWAActive
DSH500064AVChildDSHHARBORVIEW MEDICAL CENTERNORM MALE - Hepatitis and Liver Clinic908 Jefferson StSEATTLEWAActive
DSH500064AWChildDSHHARBORVIEW MEDICAL CENTERNINTH & J - Stroke Clinic908 JEFFERSON STSEATTLEWAActive
DSH500064AXChildDSHHARBORVIEW MEDICAL CENTERGI CLINIC908 Jefferson StSeattleWAActive
DSH500064AYChildDSHHARBORVIEW MEDICAL CENTERHEMATOLOGY CLINIC908 Jefferson StSeattleWAActive
DSH500064AZChildDSHHARBORVIEW MEDICAL CENTERGeneral Surgery Clinic908 Jefferson StSeattleWAActive
DSH500064BChildDSHHARBORVIEW MEDICAL CENTERFoot, Ankle, and Podiatry Clinic908 Jefferson StSeattleWAActive
DSH500064BAChildDSHHARBORVIEW MEDICAL CENTERADULT UROLOGY CLINIC908 Jefferson StSeattleWAActive
DSH500064BBChildDSHHARBORVIEW MEDICAL CENTERCHEST CLINIC908 Jefferson StSeattleWAActive
DSH500064BCChildDSHHARBORVIEW MEDICAL CENTERRENAL CLINIC908 Jefferson StSeattleWAActive
DSH500064BDChildDSHHARBORVIEW MEDICAL CENTERCHRONIC FATIGUE CLINIC410 9th AvenueSeattleWATerminated
DSH500064BEChildDSHHARBORVIEW MEDICAL CENTERENDOSCOPY410 9th AvenueSeattleWAActive
DSH500064BFChildDSHHARBORVIEW MEDICAL CENTEREYE INSTITUTE OR908 Jefferson StSeattleWAActive
DSH500064BGChildDSHHARBORVIEW MEDICAL CENTERHMC RADIOLOGY DIAGNOSI - Radiology908 Jefferson St.SeattleWAActive
DSH500064BHChildDSHHARBORVIEW MEDICAL CENTERHMC NUCLEAR MEDICINE - Radiology-Diagnostics908 Jefferson St.SeattleWATerminated
DSH500064BJChildDSHHARBORVIEW MEDICAL CENTERMRI MAGNETIC RESONANCE IMAGING - MRI908 Jefferson St.SeattleWAActive
DSH500064BKChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - Computed Tomography H908 Jefferson St.SeattleWAActive
DSH500064BLChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - MOD MAX Attendance Incentives Grant908 Jefferson St.SeattleWAActive
DSH500064BMChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - Adult Medicine Clinic319 Terry AveSeattleWAActive
DSH500064BNChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - Operating Room H410 9th AveSeattleWATerminated
DSH500064BPChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - Recovery Room410 9th AveSeattleWAActive
DSH500064BQChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - CVD19 Vaccine DIST H319 Terry AveSeattleWATerminated
DSH500064BRChildDSHHARBORVIEW MEDICAL CENTERHMC - PSQ MED RESPITE EXP800 Jefferson St.SeattleWAActive
DSH500064BSChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - PSQ 1811 EASTLAKE206 3rd Ave SSeattleWATerminated
DSH500064BTChildDSHHARBORVIEW MEDICAL CENTERHMC - RETINA CENTER750 Republican St. Building FSeattleWATerminated
DSH500064BUChildDSHHARBORVIEW MEDICAL CENTERHMC - PSQ SAM206 3rd Ave SSeattleWATerminated
DSH500064BVChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - Familiar Aces ICMT401 BroadwaySeattleWAActive
DSH500064BWChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - Hobson Place2120 S. Plum St.SeattleWAActive
DSH500064BXChildDSHHARBORVIEW MEDICAL CENTERHarborview Medical Center - HMHS Housing & Employment401 BroadwaySeattleWAActive
DSH500064BYChildDSHHARBORVIEW MEDICAL CENTERWA-STR MAT - OBOT RESPONSE CLINIC401 Broadway StSeattleWAActive
DSH500064BZChildDSHHARBORVIEW MEDICAL CENTERCARDIOLOGY CLINIC H - H HEART INSTITUTE908 Jefferson StSeattleWAActive
DSH500064CChildDSHHARBORVIEW MEDICAL CENTERSpine Center908 Jefferson StSEATTLEWAActive
DSH500064CAChildDSHHARBORVIEW MEDICAL CENTERPULMONARY FUNCTION H - H PULMONARY FUNCTION LAB908 Jefferson StSeattleWAActive
DSH500064CBChildDSHHARBORVIEW MEDICAL CENTERCardiology - Echo Lab908 Jefferson StSeattleWAActive
DSH500064CCChildDSHHARBORVIEW MEDICAL CENTERHarborview Diabetes Endocrinology Clinic - Harborview Diabetes Endocrinology Clinic908 Jefferson StSeattleWAActive
DSH500064CDChildDSHHARBORVIEW MEDICAL CENTERProsthetic/Orthotic Service - H Prosthetic & Orthotic Maleng908 Jefferson St.SeattleWAActive
DSH500064CEChildDSHHARBORVIEW MEDICAL CENTERSpine Center PSSSP - Spine Sports Med PSSP908 Jefferson St,SeattleWAActive
DSH500064CFChildDSHHARBORVIEW MEDICAL CENTERWA-STR MAT - OBOT HOBSON - OBOT Hobson2120 South Plum St.SeattleWAActive
DSH500064CGChildDSHHARBORVIEW MEDICAL CENTERWA-STR MAT - OBOT PSQ - OBOT Pioneer Square206 3rd Ave SSeattleWAActive
DSH500064DChildDSHHARBORVIEW MEDICAL CENTERThoracic Clinic908 Jefferson StSeattleWAActive
DSH500064EChildDSHHARBORVIEW MEDICAL CENTEREye Institute908 Jefferson StSeattleWAActive
DSH500064FChildDSHHARBORVIEW MEDICAL CENTERFamily Medicine Clinic401 BroadwaySeattleWAActive
DSH500064GChildDSHHARBORVIEW MEDICAL CENTERHMHS Addictions Clinic401 BroadwaySeattleWATerminated
DSH500064HChildDSHHARBORVIEW MEDICAL CENTERAddictions Clinic401 BroadwaySeattleWAActive
DSH500064JChildDSHHARBORVIEW MEDICAL CENTERSTD Clinic908 JeffersonSeattleWATerminated
DSH500064KChildDSHHARBORVIEW MEDICAL CENTERSTD Chlamydia Program908 JeffersonSeattleWATerminated
DSH500064LChildDSHHARBORVIEW MEDICAL CENTERSTD Syphilis Elimination908 JeffersonSeattleWATerminated
DSH500064MChildDSHHARBORVIEW MEDICAL CENTERSTD Partner Project908 JeffersonSeattleWATerminated
DSH500064NChildDSHHARBORVIEW MEDICAL CENTERMental Health Intake & Brief Intervention Services Clinic401 BroadwaySeattleWAActive
DSH500064PChildDSHHARBORVIEW MEDICAL CENTERVascular Clinic908 Jefferson StSeattleWAActive
DSH500064QChildDSHHARBORVIEW MEDICAL CENTERPioneer Square SAMHSA206 3rd Avenue SouthSeattleWATerminated
DSH500064RChildDSHHARBORVIEW MEDICAL CENTERPioneer Square Heathcare for Homeless206 3rd Avenue SouthSeattleWATerminated
DSH500064SChildDSHHARBORVIEW MEDICAL CENTERPioneer Square HSP Access Program206 3rd Avenue SouthSeattleWATerminated
DSH500064TChildDSHHARBORVIEW MEDICAL CENTERPioneer Square Respite ProgramJefferson TerraceSeattleWATerminated
DSH500064UChildDSHHARBORVIEW MEDICAL CENTERHMHS Mental Health Recovery Svcs401 BroadwaySeattleWAActive
DSH500064VChildDSHHARBORVIEW MEDICAL CENTERPioneer Square 3rd Avenue Clinic2028 3rd AveSeattleWAActive
DSH500064WChildDSHHARBORVIEW MEDICAL CENTEROtolaryngology Specialty Clinic908 JeffersonSeattleWATerminated
DSH500064XChildDSHHARBORVIEW MEDICAL CENTERHand Institute Clinic908 Jefferson StSeattleWAActive
DSH500064YChildDSHHARBORVIEW MEDICAL CENTERPalliative Medicine Clinic908 Jefferson StSeattleWAActive
DSH500064ZChildDSHHARBORVIEW MEDICAL CENTERPioneer Square 2nd Avenue Clinic2124 4th AveSeattleWATerminated
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (AK) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (CA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (ID) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (KY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (MT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (NJ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (NY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (OH) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (OR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (WA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (AZ) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (CO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (IL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (HI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (CT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (MD) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (IN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (IA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (ME) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (TN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (MN) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (MA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (MI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (NV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (MS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (ND) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (NM) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (PA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (FL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (VT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (TX) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (VA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (AR) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (AL) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (WI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (UT) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (DE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (GA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (KS) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (LA) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (MO) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (NE) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (NC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (OK) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (RI) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (SC) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (WV) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710102264 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1154712636 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1861030249 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1750647707 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1083121545 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1235777616 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1669416004 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1659027985 (WY) 8/28/2024 3:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1710684469 (WY) 8/28/2024 3:24 PM
DetailsLast Recertification DateUpdateRecertification9/1/2023 9:43:54 AM8/28/2024 3:24:39 PM8/28/2024 3:24 PM
AddressesBilling AddressInsertGroup Change Request UW Medicine PO BOX 45404 Seattle, WA 981457/15/2024 6:32 PM
Medicaid BillingNPI: NumberDeleteChange Request1053359729 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1083121545 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1154712636 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1235777616 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1669416004 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1710102264 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1750647707 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1861030249 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1659027985 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1710684469 (SD) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1053359729 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1710102264 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1154712636 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1861030249 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1750647707 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1083121545 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1235777616 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1669416004 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1659027985 (NH) 7/15/2024 1:09 AM
Medicaid BillingNPI: NumberDeleteChange Request1710684469 (NH) 7/15/2024 1:09 AM
AddressesMain AddressUpdateChange Request 410 9th Avenue Seattle, WA 98104-2499 908 Jefferson St Seattle, WA 98104-24992/7/2024 3:13 PM
AddressesShipping AddressDeleteRecertificationHarborview Medical Center Pharmacy 325 9th Ave Seattle, WA 98104-2499 9/1/2023 9:43 AM
DetailsLast Recertification DateUpdateRecertification9/15/2022 6:20:35 PM9/1/2023 9:43:54 AM9/1/2023 9:43 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request DE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request GA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request KS8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request LA8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request MO8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NE8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request OK8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request RI8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request SC8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WV8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request WY8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10533597298/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17101022648/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 11547126368/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18610302498/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17506477078/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 10831215458/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12357776168/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16694160048/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16590279858/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 17106844698/11/2023 2:02 PM
Medicaid BillingNPI: StateInsertGroup Change Request NH8/11/2023 2:02 PM
ContactsAuthorizing OfficialUpdateChange RequestBROOM, MAUREEN Enterprise Finance Officer UW Medicine 2065985362Cabe, Jacqueline L Chief Financial Officer UW Medicine 20661698864/4/2023 12:10 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request AK3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request AZ3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request CA3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request CO3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request IL3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request HI3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request CT3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request ID3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request MD3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request KY3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request IN3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request IA3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request ME3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request TN3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request OR3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request MN3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request MA3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request MI3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request NV3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request MT3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request MS3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request ND3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request NJ3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request NM3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request OH3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request NY3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request SD3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request PA3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request FL3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request WA3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request VT3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request TX3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request VA3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request AR3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request AL3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request WI3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 17106844693/10/2023 2:58 PM
Medicaid BillingNPI: StateInsertChange Request UT3/10/2023 2:58 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request AK1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request AZ1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request CA1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request CO1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request CT1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request HI1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request ID1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request IL1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request IN1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request KY1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request IA1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request MA1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request MD1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request ME1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request ND1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request NM1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request NJ1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request NV1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request MT1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request MN1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request MI1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request MS1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request OH1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request NY1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request OR1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request SD1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request PA1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request WA1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request TN1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request TX1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request VT1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request VA1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request AR1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request AL1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request FL1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request UT1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertChange Request 16590279851/9/2023 9:03 PM
Medicaid BillingNPI: StateInsertChange Request WI1/9/2023 9:03 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AR9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10831215459/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AR9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 11547126369/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AR9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 12357776169/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AR9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 16694160049/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AR9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17101022649/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AR9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17506477079/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AR9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 18610302499/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AR9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10831215459/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 11547126369/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 12357776169/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 16694160049/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17101022649/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17506477079/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 18610302499/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification AL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification FL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10831215459/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification FL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 11547126369/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification FL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 12357776169/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification FL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 16694160049/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification FL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17101022649/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification FL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17506477079/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification FL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 18610302499/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification FL9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification UT9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10831215459/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification UT9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 11547126369/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification UT9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 12357776169/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification UT9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 16694160049/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification UT9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17101022649/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification UT9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17506477079/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification UT9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 18610302499/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification UT9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification WI9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 10831215459/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification WI9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 11547126369/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification WI9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 12357776169/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification WI9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 16694160049/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification WI9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17101022649/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification WI9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 17506477079/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification WI9/15/2022 6:20 PM
Medicaid BillingNPI: NumberInsertRecertification 18610302499/15/2022 6:20 PM
Medicaid BillingNPI: StateInsertRecertification WI9/15/2022 6:20 PM
DetailsLast Recertification DateUpdateRecertification8/30/2021 12:06:37 PM9/15/2022 6:20:35 PM9/15/2022 6:20 PM
DetailsLast Recertification DateUpdateRecertification9/3/2020 12:30:41 PM8/30/2021 12:06:37 PM8/30/2021 12:06 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AK10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AK10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AK10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AK10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AK10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AK10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AK10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AZ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AZ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AZ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AZ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AZ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AZ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request AZ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CO10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CO10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CO10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CO10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CO10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CO10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CO10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request CT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request HI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request HI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request HI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request HI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request HI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request HI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request HI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ID10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ID10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ID10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ID10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ID10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ID10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ID10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IL10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IL10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IL10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IL10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IL10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IL10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IL10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request IA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request KY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request KY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request KY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request KY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request KY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request KY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request KY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ME10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ME10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ME10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ME10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ME10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ME10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ME10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MI10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MS10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MS10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MS10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MS10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MS10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MS10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MS10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request MT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NV10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NV10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NV10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NV10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NV10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NV10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NV10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NJ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NJ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NJ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NJ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NJ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NJ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NJ10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NM10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NM10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NM10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NM10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NM10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NM10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NM10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request NY10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ND10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ND10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ND10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ND10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ND10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ND10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request ND10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OH10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OH10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OH10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OH10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OH10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OH10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OH10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OR10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OR10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OR10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OR10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OR10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OR10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request OR10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request PA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request PA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request PA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request PA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request PA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request PA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request PA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TX10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TX10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TX10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TX10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TX10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TX10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TX10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request TN10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request SD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request SD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request SD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request SD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request SD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request SD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request SD10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request VT10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 108312154510/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request WA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 115471263610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request WA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 123577761610/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request WA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 166941600410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request WA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 171010226410/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request WA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 175064770710/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request WA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertChange Request 186103024910/14/2020 12:19 PM
Medicaid BillingNPI: StateInsertChange Request WA10/14/2020 12:19 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification AK9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification AZ9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification CA9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification CO9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification CT9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification HI9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification ID9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification IL9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification IN9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification IA9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification KY9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification ME9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification MD9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification MA9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification MI9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification MN9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification MS9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification MT9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification NV9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification NJ9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification NM9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification ND9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification NY9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification OH9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification OR9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification PA9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification SD9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification TN9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification TX9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification VT9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification VA9/3/2020 12:30 PM
Medicaid BillingNPI: NumberInsertRecertification 10533597299/3/2020 12:30 PM
Medicaid BillingNPI: StateInsertRecertification WA9/3/2020 12:30 PM
Medicaid BillingNPI: NumberDeleteRecertification1053359729 ( ) 9/3/2020 12:30 PM
DetailsLast Recertification DateUpdateRecertification9/11/2019 1:02:22 PM9/3/2020 12:30:41 PM9/3/2020 12:30 PM
DetailsLast Recertification DateUpdateRecertification8/21/2018 11:11:08 AM9/11/2019 1:02:22 PM9/11/2019 1:02 PM
DetailsLast Recertification DateUpdateRecertification11/20/2017 6:59:19 PM8/21/2018 11:11:08 AM8/21/2018 11:11 AM
DetailsLast Recertification DateUpdateRecertification8/25/2016 12:00:00 AM11/20/2017 6:59:19 PM11/20/2017 6:59 PM
ContactsPrimary ContactInsertChange Request Patel, Sumona Pharmacy Audit and Compliance Manager UW Medicine 20659869369/21/2017 12:40 PM
ContactsAuthorizing OfficialUpdate BROOM, MAUREEN Enterprise Finance Officer 2065985362BROOM, MAUREEN Enterprise Finance Officer UW Medicine 20659853629/21/2017 11:53 AM
ContactsSigned ByInsert  Mitchell, Lori CFO, UW Medicine 20661698868/9/2017 2:15 PM
ContactsAuthorizing OfficialInsert  BROOM, MAUREEN Enterprise Finance Officer 20659853627/17/2017 3:24 PM
DetailsLast Recertification DateUpdate 8/6/2015 12:00:00 AM8/25/2016 12:00:00 AM8/25/2016 5:48 PM
AddressesMain AddressInsert   410 9th Avenue Seattle, WA 98104-24998/25/2016 5:48 PM
AddressesShipping AddressInsert  Harborview Medical Center Pharmacy 325 9th Ave Seattle, WA 98104-24994/25/2016 1:52 PM
DetailsLast Recertification DateUpdate  8/6/2015 12:00:00 AM8/6/2015 5:11 PM
Medicaid BillingNPI: NumberInsert  10533597294/21/2015 2:37 PM
DatesParticipating Approval DateUpdate  11/5/2014 12:00:00 AM11/5/2014 6:12 PM
DetailsStateUpdate PendingActive11/5/2014 6:12 PM
DatesStart DateUpdate  1/1/2015 12:00:00 AM11/5/2014 6:12 PM
Details340B IDUpdate OUTPATIENT_ONLINE_REG_47937DSH500064AB11/5/2014 1:30 PM
Details340B IDUpdate  OUTPATIENT_ONLINE_REG_4793710/30/2014 12:05 PM
DetailsLast Recertification DateInsert   10/30/2014 12:05 PM
DetailsGrant NumberInsert   10/30/2014 12:05 PM
Details340B IDInsert   10/30/2014 12:05 PM
DetailsIs Authorizing Official EHB DataInsert   10/30/2014 12:05 PM
DatesLast Date That 340B Drugs PurchasedInsert   10/30/2014 12:05 PM
DetailsMedicare Provider NumberInsert  50006410/30/2014 12:05 PM
DetailsEntity NameInsert  HARBORVIEW MEDICAL CENTER10/30/2014 12:05 PM
DetailsProgram CodeInsert  DSH10/30/2014 12:05 PM
DetailsEntity SubnameInsert  Vascular Lab10/30/2014 12:05 PM
DatesParticipating Approval DateInsert   10/30/2014 12:05 PM
DetailsStateInsert  Pending10/30/2014 12:05 PM
DatesRegistration DateInsert  10/30/2014 12:00:00 AM10/30/2014 12:05 PM
DatesSigned By DateInsert  10/30/2014 12:00:00 AM10/30/2014 12:05 PM
DatesStart DateInsert   10/30/2014 12:05 PM
TerminationsTermination CommentsInsert   10/30/2014 12:05 PM
TerminationsTermination DateInsert   10/30/2014 12:05 PM
TerminationsTermination Effective DateInsert   10/30/2014 12:05 PM
TerminationsTermination ReasonInsert   10/30/2014 12:05 PM