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Provider Profile

The Provider Profile function maintains information that has been entered for a provider during the application process.  The function is accessed from the Account Summary page (PM0083) through the Account Option item named Provider Profile.  The following information is presented on the Provider Profile page (PM0020).

Initial Application Date

The date on which the provider initially applied for a license is displayed in this field.

Provider Name

The name of the provider is displayed in this field. 

Facility Address

The site address is displayed in this section.

Postal Address

The mailing address is displayed in this section.

EIN

If the provider has an Employer Identification Number, the number is displayed in this field.

SSN

If the provider has an entered Social Security Number, the number is displayed in this field.

E-mail Address

If the provider has an entered e-mail address, the information is displayed in this field.

Contact Phone Number

The contact phone number for the provider is displayed in this field.

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