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Get DEA Waiver Form - Blue Cross Blue Shield Of Massachusetts

In these cases the applicant must submit the signed and dated waiver Please complete the information below sign date and fax it to 617-246-3163. You can also scan and e-mail the completed form to Provider-Enrollment bcbsma.com. Important note If you are an NPPCP or a PAPCP and do not have a DEA certificate please contact Network Services at 1-800-316-2583.

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