Are you sure you want to logout?
If you navigate away from this page, you will lose unsaved data. Are you sure you want to logout?
Wednesday 04/21/2021 09:13 PM CST
Provider Enrollment - Status
Back to Home
Enter your assigned tracking number and Tax ID (Employee Identification Number or Social Security Number) to verify the current status of your enrollment application. For any further queries, please contact Provider enrollment at (501) 376-2211 or (800) 457-4454 option 0 then 3.
(in red) indicates required fields when the ADD button is selected.
Tax ID (Employee Identification Number or Social Security Number)