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This form must be completed by a medical provider to authorize diabetes management care.

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Physical Address:
6400 Uptown Blvd. NE
Albuquerque NM 87110

Mailing Address:
P.O. Box 25704
Albuquerque NM 87125-0704

APS Administration:
(505) 880-3700

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(505) 855-9040
servicecenter@aps.edu

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