Application for a Medicare provider number and, or prescriber number for allied health and non-medical health professionals form (HW093)
Use this form if you are applying for an initial or subsequent Medicare provider number or a PBS prescriber number or both.
Download and complete the Application for a Medicare provider number and, or prescriber number for allied health and non-medical health professionals form.
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.
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Page last updated: 4 February 2020