Free cookie consent management tool by
TermsFeed
I am a:
Select
Distributor
Manufacturer
Provider
Menu
Home
About Us
Who We Are
Mission
Why Local
Markets Served
Testimonials
New To GPO
s
?
Partners
Provista
Distributors
Suppliers
NDC
NuEdge Business
Resources
FAQ
s
Industry Resources
Enrollment Forms
Find a Distributor
Partner Login
Contact Us
Inquiry
Request a Quote
Contact Info
Blog
Provider Enrollment Form
Facility Name
*
Contact Name
*
Title
*
Address
*
City
*
State
*
Select
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GUAM
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Additional Locations
Facility Name
Address
Unit/Suite
City
State
Select
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GUAM
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
Phone
*
Fax
Email
Federal Tax ID
DEA
HIN
Customer Type
Select
Stand Alone
System
Satellite
Customer Class of Trade
*
Select
Ambulatory Care
Clinic/Phys Practice
Dental
HMO-Closed
Home Health
Long Term Care
Physical Rehab
Retail Pharmacy
Corporate & Business
Primary Description
*
Select
Acute Medical School
Cardiac Hospital
General Medical & Surgical
Long Term Care Acute Hospital
Psychiatric Hospital
Rehab Hospital
Surgical Hospital
Other
Primary Description
*
Select
Ambulatory Surgery Center
Dialysis
Imaging Center
Urgent Care Center
Primary Description
*
Select
Ambulance Service/EMT
Clinic/Medical Group
Laboratory
Student Health Clinic
Other
Primary Description
*
Select
Endodontist
General Practice
Group Practice
Oral Surgery
Periodontist
Specialty
Primary Description
*
Select
Group Model HMO
Managed Care Plan
Primary Description
*
Select
Durable Medical Equipment
Home Health Services
Home Infusion Center
Hospice
Specialty Pharmacy
Primary Description
*
Select
Assisted Living
Long Term Care
Rehabilitation
Primary Description
*
Select
Athletic Trainer
Chiropractor
Occupational Therapy
Physical Therapy
Primary Description
*
Primary Description
*
Select
College or University
Community College
K-12
Early Learning
Primary Description
*
Select
Corporations & Businesses
Correctional Facilities
Faith Based Organizations
Select Distributor
*
Select
Discount Disposables
Distributor Contact/Rep
E-Signature (full-name)
*
I would like to declare NuEdge Alliance as my primary GPO group.
Next
Partner Portals:
Distributors
Manufacturers
Enroll Today!
NUEDGE ALLIANCE, LLC © 2024 All Rights Reserved