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1835 SUBJECT: Distribution of Revised Form CMS-855s Medicare Provider/Supplier Enrollment Applications - (Formerly Form HCFA-855) Dated November 1, 2001 This Program Memorandum (PM) provides distribution instructions for the November 1, 2001, versions of the Form CMS-855s. The November 1, 2001, versions of Form CMS-855s will be delivered to all intermediaries, carriers, the National Supplier Clearinghouse, and regional offices by October 29, 2001. This implementation requires that contrac.

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