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Form 470-5111 Ordering / Referring Provider Enrollment Application - Iowa
What Is Form 470-5111?
This is a legal form that was released by the Iowa Department of Human Services - a government authority operating within Iowa. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 470-5111?
A: Form 470-5111 is an Ordering/Referring Provider Enrollment Application for Iowa.
Q: Who needs to fill out Form 470-5111?
A: Medical providers in Iowa who want to enroll as ordering/referring providers need to fill out Form 470-5111.
Q: What is the purpose of Form 470-5111?
A: The purpose of Form 470-5111 is to enroll medical providers in Iowa as ordering/referring providers.
Q: Are there any fees associated with Form 470-5111?
A: There may be fees associated with Form 470-5111 for Iowa. You should contact the appropriate state agency or your local healthcare provider enrollment office for more information.
Form Details:
- Released on February 1, 2013;
- The latest edition provided by the Iowa Department of Human Services;
- 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 470-5111 by clicking the link below or browse more documents and templates provided by the Iowa Department of Human Services.
Download Form 470-5111 Ordering / Referring Provider Enrollment Application - Iowa
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