Additional Practice Location

Additional Practice Location
Additional Practice Location

Use this form if you are adding additional provider numbers which require the postal address, contact and bank information to be the same as an existing registered Provider Number. The existing registered Provider Number has to be listed in the top left box of the form. Where there are more than 7 Provider Numbers to be registered, you can use multiple Additional Practice Location forms to provide the required information. Please do not use this form to update your postal address. The Provider Registration form can be used to update all relevant information.