BRAVO HEALTH INC. (333) PAYER (365.12)
Name
Value
PAYER NAME
BRAVO HEALTH INC.
VA NATIONAL ID
VA506
EDI ID NUMBER - PROF
52192
EDI ID NUMBER - INST
52192
APPLICATION
EIV
NATIONALLY ENABLED: Not Enabled
*AUTO-ACCEPT: NO
*IDENT REQUIRES SUBSCRIBER ID: YES
*TRANSMIT SSN: NO
DATE/TIME CREATED: 2016-10-28 15:06:21
*FUTURE SERVICE DAYS: 9999
*PAST SERVICE DAYS: 9999
AUTO-UPDATE: NO
270 REQUIRES SUB ID: YES
FUTURE SERVICE DAYS: 9999
PAST SERVICE DAYS: 9999
