Provider Information
Provider Code
*
Provider Type
*
Provider Name
*
DOH/DHA/DHCC/MOH Licence Number
*
Trade License Expiry Date
*
DOH/DHA/DHCC/MOH Licence Expiry Date
*
Primary Health Care Center (PHCC)
*
Yes
No
Longitude
Latitude
Contact Information
Address
*
Country
*
Emirates*
Telephone Number
*
Fax Number
*
Contact Person
*
Mobile Number
*
Mobile Number - Approvals
PO Box
*
E-mail for Finance/RA
*
E-mail for Insurance Dept.
*
E-mail for Approval 1
*
E-mail for Approval 2
*