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Get Provider Web Site Change Senior Access Administrator Form
D form to 617-673-0312 or mail it to the following address: Tufts Health Plan Provider Services Web Access Management 705 Mt. Auburn Street Watertown, MA 02471 * Insert name of provider, provider group or facility * NPI The above named provider ( Provider ) hereby designates the individual listed below as the new Senior Access Administrator for Provider s Tufts Health Plan website account. Provider understands that the designated Senior Access Administrator: (1) may grant and terminate.
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