Submit your referral directly into the CHCS/AHLTA/GENESIS system and include the following information:
This is an order for a __(Product Name)__ Code__(HCPCS)__as listed from Tactical Rehabilitation (Fed Tax ID 46-2082171)
LISTED BELOW ARE PROVIDERS AUTHORIZED TO SUBMIT REQUEST FOR DME.
Authorized Provider Signatures:
- MD
- DO
- GMO Op Forces
- IDC
- PA-C
- NP-C
- DPT
- CCNS
- CRNA
- CPNS
- DPM