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When Block 2 5 of the CMS - 1 5 0 0 contains the provider's employee identification number ( EIN ) , enter _ _

When Block

25

of the CMS

- 1500

contains the provider's employee identification number

(

EIN

),

enter

_____

after the first two digits of the EIN.

.

a hyphen

.

a space

.

no punctuation or space

.

the provider's SSN

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