Application for an additional location Medicare provider number for a medical practitioner form (HW062)

Complete this form if you are an existing Medicare provider applying for a Medicare provider number for a new location, to re-open a closed location or to close an existing Medicare provider number. Your application and supporting documentation should be sent to the Australian Government Department of Human Services prior to your proposed commencement date.

Aged care online

This form can be completed online. Read more about Aged care online.

Page last updated: 20 October 2016

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