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2019-084-E Health - Piedmont Health Services WIC business associate agreement
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2019-084-E Health - Piedmont Health Services WIC business associate agreement
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Last modified
2/22/2019 10:25:12 AM
Creation date
2/22/2019 10:01:42 AM
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Template:
Contract
Date
2/18/2019
Contract Starting Date
2/18/2019
Contract Document Type
Agreement
Amount
$0.00
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9 <br />October 2013 <br />Associate affirms that they are in compliance with Article 3 of Chapter 64 if the North Carolina General <br />Statutes. <br /> <br />IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year written <br />above. <br /> <br />COVERED ENTITY: BUSINESS ASSOCIATE: <br /> <br />By:_________________________________ By:___________________________________ <br /> <br />Title:________________________________ Title:__________________________________ <br />DocuSign Envelope ID: A93029DD-E265-44AF-B27A-FDC58C54BA50 <br /><br />
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