33 Billing Provider NPI Info & Phone #

Enter the provider’s or supplier’s billing name, doing business as (DBA) address, zip code, and phone number. Enter the phone number in the area to the right of the field title.

Enter the name and address information in the following format:
• 1st line – name
• 2nd line – address
• 3rd line – city, state, and zip code

Field 33 identifies the provider that is requesting to be paid for the services rendered and should always be completed.

Do not use commas, periods, or other punctuation in the address (for example, 123 N Main Street 101 instead of 123 N. Main Street, #101).

Enter a space between town name and state code; do not include a comma.

When entering a nine-digit zip code, include a hyphen. Do not use a hyphen or space as a separator within the telephone number.