Skip to content
717-747-1159
info@rachealhhc.com
1600 Sixth Avenue, suite 116B, York, PA, 17403
Home
About Us
Services
Pediatrics
Companionship
Personal Care
Skilled Nursing
Careers
Resources
Forms
Contact Us
Blog
Home
About Us
Services
Pediatrics
Companionship
Personal Care
Skilled Nursing
Careers
Resources
Forms
Contact Us
Blog
Schedule Consultation
Home
About Us
Services
Pediatrics
Companionship
Personal Care
Skilled Nursing
Careers
Resources
Forms
Contact Us
Blog
Schedule Consultation
Medicare ID
Admitting representative shall
VERIFY ORIGINAL
Medicare Card and Claim Number:
Patient Name:
Date:
MM slash DD slash YYYY
Medicare Claim Number:
Other Insurance:
Signature of Verifying Agency Representative:
Comments
This field is for validation purposes and should be left unchanged.
This is a Sample of a Medicare Card
Schedule An Appointment today!
Name
Email
Phone Number
Message
Submit