Provider registration/update

Pharmacy providers - Provider registration/update

To register as a new provider, or update information for an existing provider, complete the applicable forms found below. If you have any questions or concerns regarding provider updates or registration, please contact us by email at pamt@ab.bluecross.ca, or by calling our toll-free number 1-844-498-8292.

New provider registration

Location of pharmacy:


Alberta

Please complete the Alberta registration form, then print and sign it. The form can then be

Please note that it is not necessary to mail the original copy to our office.

British Columbia/Saskatchewan/Territories

Please complete the BC-SK-Territories registration form, then print and sign it. The form can then be

Please note that it is not necessary to mail the original copy to our office.

Manitoba and East

Please review the Guidelines to Pride RT. Complete the MB East registration form, then print and sign it. The form can then be

Please note that it is not necessary to mail the original copy to our office.

Existing provider update

For updates to the following information for existing providers, complete the Provider Information Change form:

  • Operating name
  • Site or mailing address
  • Phone or fax number

For updates to banking information for existing providers, complete the Direct Deposit Authorization form.


For updates to the legal name, please contact us by email pamt@ab.bluecross.ca, or by calling our toll-free number 1-844-498-8292.

?
Where to next?

View our resources

Back to top