Diagnostic Laboratories/Clinical Medical 23 LAB 72 Laboratory 291U00000X Laboratory PERSONAL CARE Nursing Service Related SERVICES Providers Technician Personal 24 (IN-ST) 5A PCS-LTC 3747P1801X Care Attendant LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc PERSONAL CARE Nursing Service Related SERVICES Providers Technician Personal 24 (IN-ST) 5B 3747P1801X Care Attendant PERSONAL Personal CARE Assistant Nursing Service Related SERVICES Service Providers Technician Personal 24 (IN-ST) 5C (PAS) 3747P1801X Care Attendant PERSONAL CARE PCS-LTC, Nursing Service Related SERVICES Providers Technician Personal 24 (IN-ST) 5D 3747P1801X Care Attendant PERSONAL Personal CARE Assistant Nursing Service Related SERVICES Service Providers Technician Personal 24 (IN-ST) 5E (PAS) 3747P1801X Care Attendant PERSONAL CARE Nursing Service Related SERVICES Providers Technician Personal 24 (IN-ST) 5F PAS 3747P1801X Care Attendant PERSONAL PCS-LTC, CARE Nursing Service Related SERVICES Providers Technician Personal 24 (IN-ST) 5G PAS 3747P1801X Care Attendant Portable MOBILE Supplier (Billing Ambulatory Health Care THRPY Facilities/Clinic-Center, 25 CT 63 261QR0208X Radiology, Mammography 26 PHARMACY 87 All Other 333600000X Suppliers/Pharmacy General DENTIST Dentistry 27 (IND & GP) 66 (DDS/DMS) 122300000X Dental Providers Dentist Oral and DENTIST Dental Providers - Dentists - Oral 27 (IND & GP) 67 Surgery 1223S0112X and Maxillofacial Surgery DENTIST Pediatric Dental Providers - Dentists - 27 (IND & GP) 68 Dentistry 1223P0221X Pediatric Dentistry DENTIST Dental Providers - Dentists - 27 (IND & GP) 6N Endodontist 1223E0200X Endodontics
23 LAB 72 Diagnostic Laboratory 291U00000X Laboratories/Clinical Medical Laboratory 24 PERSONAL CARE SERVICES (IN-ST) 5A PCS-LTC 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant LTX_Prov_ Specialty_ Desc LTX_Taxonomy_Desc 24 PERSONAL CARE SERVICES (IN-ST) 5B 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant 24 PERSONAL CARE SERVICES (IN-ST) 5C Personal Assistant Service (PAS) 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant 24 PERSONAL CARE SERVICES (IN-ST) 5D PCS-LTC, 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant 24 PERSONAL CARE SERVICES (IN-ST) 5E Personal Assistant Service (PAS) 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant 24 PERSONAL CARE SERVICES (IN-ST) 5F PAS 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant 24 PERSONAL CARE SERVICES (IN-ST) 5G PCS-LTC, PAS 3747P1801X Nursing Service Related Providers Technician Personal Care Attendant 25 MOBILE THRPY CT 63 Portable Supplier (Billing 261QR0208X Ambulatory Health Care Facilities/Clinic-Center, Radiology, Mammography 26 PHARMACY 87 All Other 333600000X Suppliers/Pharmacy 27 DENTIST (IND & GP) 66 General Dentistry (DDS/DMS) 122300000X Dental Providers Dentist 27 DENTIST (IND & GP) 67 Oral and Surgery 1223S0112X Dental Providers - Dentists - Oral and Maxillofacial Surgery 27 DENTIST (IND & GP) 68 Pediatric Dentistry 1223P0221X Dental Providers - Dentists - Pediatric Dentistry 27 DENTIST (IND & GP) 6N Endodontist 1223E0200X Dental Providers - Dentists - Endodontics
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx