To receive an application, please click on the following links.
DME Application
DME Contract
DUAL Contract
Managed Care Contract List 2011
O&P Application
O&P Contract
W9 Form
If you prefer, you can email info@integrah.com or call our Vice President of Provider Relations and Contracting at 718.369.0012 ext 331 and include the following information:
- Name
- Business
- Phone Number
- Number of Locations
- Address 1
- Address 2
- City, State, Zip
- Type of Provider (DME or O&P)
