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Form DOH-4408 Provider Status Change - New York
What Is Form DOH-4408?
This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the Form DOH-4408 Provider Status Change?A: Form DOH-4408 Provider Status Change is a document used in New York to request a change in provider status.
Q: Who uses the Form DOH-4408 Provider Status Change?A: Healthcare providers in New York use the Form DOH-4408 Provider Status Change.
Q: What changes can be requested using the Form DOH-4408 Provider Status Change?A: The Form DOH-4408 Provider Status Change can be used to request changes such as adding or deleting services, changing ownership, or closing a facility.
Q: How do I submit the Form DOH-4408 Provider Status Change?A: The completed Form DOH-4408 Provider Status Change should be submitted to the New York State Department of Health.
Form Details:
- Released on May 1, 2017;
- The latest edition provided by the New York State Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form DOH-4408 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.
Download Form DOH-4408 Provider Status Change - New York
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