Reporting Address and Contact Changes

When you change the location of your facility, you must complete an 855 package as CMS requires all address changes be handled consistently and through the formal 855 process. However, if you are only requesting a change in the contact person, title, or phone number in your mailing address, then you may send a letter with the revised information to your Audit Representative. Your request must be on your provider letterhead, and be signed by an officer of your company.

Please submit your contact change to the person noted below.