MEDICARE - Ambulance Billsambulancebills.com/newforms/MCare Enroll_Chg CMS 855B (041603… ·...

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MEDICARE FEDERAL HEALTH CARE PROVIDER/SUPPLIER ENROLLMENT APPLICATION Application for Health Care Suppliers that will Bill Medicare Carriers CENTERS FOR MEDICARE & MEDICAID SERVICES CMS 855B (11/2001) (Formerly HCFA 855)