Common Contracts
3 similar Medicare Private Contract contracts
MEDICARE PRIVATE CONTRACTMedicare Private Contract • April 5th, 2023
This contract is entered into by and between Dr. Kevin Hennenhoefer, DO (hereinafter called “physician”), whose principal medical office is located at 150 Providence Road, Suite 102, Chapel Hill, NC 27514 and (hereinafter called “beneficiary”), and shall become effective on this day of , 20 and shall expire on the 30 day of April, 2025 (the “opt out period”), unless otherwise renewed in accordance with the 42 U.S.C. 1395a; 42 C.F.R. 405, Subpart D.
MEDICARE PRIVATE CONTRACTMedicare Private Contract • March 19th, 2021
This contract is entered into by and between Dr. Kevin Hennenhoefer, DO (hereinafter called “physician”), whose principal medical office is located at 150 Providence Road, Suite 102, Chapel Hill, NC 27514 and (hereinafter called “beneficiary”), and shall become effective on this day of , 20 and shall expire on the 30 day of April, 2023 (the “opt out period”), unless otherwise renewed in accordance with the 42 U.S.C. 1395a; 42 C.F.R. 405, Subpart D.
MEDICARE PRIVATE CONTRACTMedicare Private Contract • July 7th, 2020
This contract is entered into by and between Dr. Kevin Hennenhoefer, DO (hereinafter called “physician”), whose principal medical office is located at 150 Providence Road, Suite 102, Chapel Hill, NC 27514 and (hereinafter called “beneficiary”), and shall become effective on this day of , 20 and shall expire on the 30 day of April, 2021 (the “opt out period”), unless otherwise renewed in accordance with the 42 U.S.C. 1395a; 42 C.F.R. 405, Subpart D.
