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WTC Health Program – NPN Provider Enrollment Agreement

WTC Health Program – NPN Provider Enrollment


Informational Links


For Enrollment as a NPN Provider

Please fill out and sign the Provider Agreement below:

NPN Providers will also need to complete an EFT Authorization Agreement

Please fill out and sign the EFT Agreement below:

To Learn More About The World Trade Center Health Program

If you have any questions or concerns regarding contracting, the best way to get up-to-date information is through our email or phone.

 

Email: WTCproject@primehealthservices.com

Phone: 1 (877) 703-6169