183-192 10 O Provider Leave blank if Character, Business business mailing right-fill Mailing Address address is not with spaces if (Country Code outside the U.S. necessary if outside U.S.) 193 Delimiter 1 Character, use the ^ character value 194-203 10 Numeric R Provider Do not enter Business dashes or Mailing Address parentheses. (Telephone Number) 204 Delimiter 1 Character, use the ^ character value 205-214 Provider Do not enter 10 Numeric O Business dashes or Mailing Address parentheses. (Fax Number) 215 Delimiter 1 Character, use the ^ character value 216-245 Provider No P.O. Box 30 Character R Business here, please use Location a physical Address (First address. line address) 246 Delimiter 1 Character, use the ^ character value 247-276 Provider 30 Character O Business Location Address (Second line address) 277 Delimiter 1 Character, use the ^ character value 278-307 Provider 30 Character R Business Location Address (City,)
183-192 Provider Business Mailing Address (Country Code if outside U.S.) Leave blank if business mailing address is not outside the U.S. 10 Character, right-fill with spaces if necessary O 193 Delimiter 1 Character, use the ^ character value 194-203 Provider Business Mailing Address (Telephone Number) Do not enter dashes or parentheses. 10 Numeric R 204 Delimiter 1 Character, use the ^ character value 205-214 Provider Business Mailing Address (Fax Number) Do not enter dashes or parentheses. 10 Numeric O 215 Delimiter 1 Character, use the ^ character value 216-245 Provider Business Location Address (First line address) No P.O. Box here, please use a physical address. 30 Character R 246 Delimiter 1 Character, use the ^ character value 247-276 Provider Business Location Address (Second line address) 30 Character O 277 Delimiter 1 Character, use the ^ character value 278-307 Provider Business Location Address (City,) 30 Character R
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx