Medical Supplier (DME) Inventory Form

The following information will help us to better connect patients with appropriate care providers. Questions about this form may be submitted to Contracting@ProviDRsCare.Net.

(If multiple Tax IDs, please complete a form for each Tax ID)

Supplies Inventory

Please indicate the types of supplies currently offered.
Max. file size: 300 MB.

Contact Information

Questions or requests for additional inventory information will be directed to the contact listed below.
Name(Required)

Contact Information:
Email: Contracting@ProviDRsCare.Net
Phone: (800) 801-9772

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