Non-Institutional Provider Service Agreement Sample Contracts

—LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY—
Non-Institutional Provider Service Agreement • September 20th, 2016 • Louisiana

(DBA BLUE CROSS AND BLUE SHIELD OF LOUISIANA), (hereinafter referred to as "CONTRACTOR"), a Louisiana corporation domiciled in the Parish of East Baton Rouge, herein represented by its duly authorized and undersigned officer, whose permanent mailing address is declared to be 5525 Reitz Avenue, Baton Rouge, Louisiana 70809, and

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