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Get Eps Eft User Authorization Agreement

Account Number Linkage to Provider Identifier: National Provider Identifier (NPI) Financial Institution Information for your NPI: This financial Institution section will collect banking information for payments made to your provider/organizational NPI. An NPI Bank Account is only required if you want deposits directed to an account different than the one assigned at the TIN level. *Financial Institution Name: Financial Institution Address *Street: *City: *State/Province: *Zip Code/Postal Co.

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