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ISA interchange Control Header GS Functional Group Header ST Transaction Set Header Trading Partner Profile Save this documents, modify the required information and e-mail them (word, html or pdf format) to: hipaa@intermedpr.com If you don't have access to e-mail please print the above documents, fill the required information, sign and mail them to: First Medical Health Plan, Inc. Sistemas de Información PO BOX 191580 San Juan PR 00919-1580 Or via FAX : 787-625-8769 Contact: hipaa@intermedpr.com
787-474-3999 Ext. 413
Last updated 10/06/2009
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