Provider Enrollment Phone Numbers:
(888) 223-3630 (Nationwide Toll-Free)
(334) 215-0111

Hours: (all times Central)
Monday-Friday 8 a.m. to 5 p.m.

Supervisor: Jeff Kochik - (334) 215-4152 - Click to send e-mail

• Forms for Provider Enrollment
• Electronic Provider Enrollment Application Portal
  

• Provider Enrollment Web Portal Training Manual

Attention Providers:
On January 9, 2012, the Alabama Medicaid Agency implemented an electronic provider enrollment application. Paper applications received through January 23, 2012 will continue to be processed. Any paper applications received on or after January 24, 2012 will no longer be accepted, and providers will be REQUIRED to use the web portal application to enroll with Medicaid.