Oakland ID Card Proof
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NC-5553 FRONT BLACK PMS 342 GREEN NC-5553 BACKER BLACK LAST PROOF DATE 4 / 6 / 09 NC-5553 Oakland Health Plan-cd Member Name Member # Effective Date Gender Date of Birth MEMBERS: Please carry this card with you at all times. For routine or urgent medical needs, contact your Primary Care Physician (PCP). For an emergency or life threatening problems, seek immediate medical attention and notify your PCP within 24 to 48 hours. PROVIDER: This card does not guarantee eligibility. To verify eligibility at anytime call 1-800-258-3669. Please note: Inpatient care is not a benefit under this program. Mail Claims to: Oakland Health Plan/ NGS American P.O. Box 7676 St. Clair Shores, MI 48080 Electronic Claims: NGS #38225 4D Pharmacy Management Pharmacy Provider Support: 1-800-522-7487 RXBin # 600428 RXPCN # 01990000 24 HOUR CUSTOMER SERVICE HELPLINE 1-800-258-3669
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Oakland ID Card Proof
Transcript of Oakland ID Card Proof
NC-5553 FRONT BLACK PMS 342 GREEN
NC-5553 BACKER BLACK
LAST PROOF DATE4 / 6 / 09
NC-5553 Oakland Health Plan-cd
� Member Name
� Member #
� Effective Date
� Gender
� Date of Birth
MEMBERS: Please carry this card with you at all times. Forroutine or urgent medical needs, contact your Primary CarePhysician (PCP). For an emergency or life threateningproblems, seek immediate medical attention and notify yourPCP within 24 to 48 hours.
PROVIDER: This card does not guarantee eligibility. Toverify eligibility at anytime call 1-800-258-3669. Pleasenote: Inpatient care is not a benefit under this program.
Mail Claims to:Oakland Health Plan/NGS AmericanP.O. Box 7676St. Clair Shores, MI 48080Electronic Claims: NGS #38225
4D Pharmacy ManagementPharmacy Provider Support: 1-800-522-7487RXBin # 600428 RXPCN # 01990000
24 HOUR CUSTOMER SERVICE HELPLINE 1-800-258-3669
