Mailing Street Address 1 Street address of the Report the mailing address of the PV 23 6/24/10 Text All 98% A0 Address1 Provider Provider / Entity Provider / Entity in Name Mailing Secondary Street Street Address 2 Report the mailing address of the PV 24 6/24/10 Text address of the All 2% B Address2 Provider Provider / Entity in PV002. Provider / Entity Name Mailing City Address City City name of the Report the mailing city address of PV 25 6/24/10 Text All 98% A0 Name Provider Provider / Entity the Provider / Entity in PV002. External Address State Mailing Code State name of the Report the mailing state address of PV 26 11/8/12 External Code char[2] All 98% A0 State Code Source 2 Provider / Entity the Provider / Entity in PV002. Source 2 - States - Text External Address Country Mailing Report the three-character country Code External Code Country name of the PV 27 Country 12/1/10 char[3] code as defined by ISO 3166-1, All 98% C Source 1 Source 1 - Provider / Entity Code Alpha 3. - Text Countries External Address Zip Report the 5 or 9 digit Zip Code as Mailing Zip Code External Code Zip code of the defined by the United States Postal PV 28 11/8/12 varchar[9] All 98% A0 Code Source 2 Source 2 - Zip Provider Service. When submitting the 9-digit - Text Zip Code do not include hyphen.
PV 23 Mailing Street Address1 Name 6/24/10 Text Address 1 Provider Street address of the Provider / Entity Report the mailing address of the Provider / Entity in All 98% A0 PV 24 Mailing Street Address2 Name 6/24/10 Text Address 2 Provider Secondary Street address of the Provider / Entity Report the mailing address of the Provider / Entity in PV002. All 2% B PV 25 Mailing City Name 6/24/10 Text Address City Provider City name of the Provider / Entity Report the mailing city address of the Provider / Entity in PV002. All 98% A0 PV 26 Mailing State Code 11/8/12 External Code Source 2 - Text Address State External Code Source 2 - States char[2] State name of the Provider / Entity Report the mailing state address of the Provider / Entity in PV002. All 98% A0 PV 27 Mailing Country Code 12/1/10 External Code Source 1 - Text Address Country External Code Source 1 - Countries char[3] Country name of the Provider / Entity Report the three-character country code as defined by ISO 3166-1, Alpha 3. All 98% C PV 28 Mailing Zip Code 11/8/12 External Code Source 2 - Text Address Zip External Code Source 2 - Zip varchar[9] Zip code of the Provider Report the 5 or 9 digit Zip Code as defined by the United States Postal Service. When submitting the 9-digit Zip Code do not include hyphen. All 98% A0