![]() Healthcare provider/Facility’s National Provider Identifier (NPI)*.To create a portal account you will need the following: If this is your first time visiting the LLS Financial Assistance Portal, you will need to register before you can start the online application. This information will not be shared and is for verification purposes only. Physician’s information (first and last name, and location).Please note that these patients will be required to submit documentation to verify identity. Patients who do not have a Social Security number or Alien ID number should call (877) 557-2672 to apply.If patient is a minor (under the age of 18), patient AND guardian’s Social Security Numbers and date of birth are required. ![]() The patient’s Social Security Number and date of birth.Please note that these patients will be required to submit documentation to verify identity.Ĭlick here to download the paper application. Patients who do not have a Social Security number or Alien ID number should call (877) 557-2672 to apply. Please note: There is a separate portal for the Co-Pay Assistance Program. Have NOT received a Patient Aid Program award in the past. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |