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Thursday, March 11, 2010

Step 1 - Provider Group Information Hospital/Provider Name Required EIN (Tax ID) Required (e.g. 54-1764182) UserName Required Password Required Address 1 Required Address 2 City Required State AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Required Zip Code Required Country AustriaBelgiumCanadaChinaDenmarkFinlandFranceGermanyHong KongIcelandItalyJapanMexicoNetherlandNorwaySouth AmericaSpainSwedenTaiwanUnited KingdomUnited States Required Phone No. 1 Required Phone No. 2 Cell Phone Fax No. Email 1 Email 2 Website Url 1 Website Url 2