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This form is used to provide information for additional locations when submitting the Inclusa Provider Application Form, or for adding new services or a new location to an existing contract.
9 paź 2012 · Great Care Services Inc is a provider established in Charlotte, North Carolina operating as a In Home Supportive Care. The healthcare provider is registered in the NPI registry with number 1356693766 assigned on October 2012.
Start by going to our website: providerexpress.com. Click on “Our Network” on the top tool bar. Click on the Facility or Hospital Based link to complete your facility application.
Great Care Services, Inc can be contacted at (704) 606-4113 or submit a request for more information. Unless Great Care Services, Inc is also certified by the Centers for Medicare & Medicaid Services, Home Care Agency (s) do not accept Medicare as payment for any care services.
Step by Step Guide to Complete the Optum Individual Clinician Application. Start by going to our website: providerexpress.com. Click on “Our Network” on the top tool bar. Click on the Individually-Contracted Clinicians link to complete your Individual Clinician Application. Completion and Submission Instructions.
PROVIDER APPLICATION FORM EB 197. PLEASE USE BLOCK LETTERS TO COMPLETE THIS FORM AND WRITE LEGIBLY. PROVIDER’S SIGNATURE. DATE. ADDITIONAL PROVIDER’S SIGNATURE. DATE. INFORMATION ON REVERSE SIDE TO BE COMPLETED. PROVIDER DATA: 1.
Find a Location Great Care Services, Inc. has 1 locations, listed below. *This company may be headquartered in or have additional locations in another country.
