Register Organization
Complete the fields below to register your organization.
The information you provide will be used by CareMetx, LLC, our affiliates, and our service providers, for your registration and participation in this program. Our
Privacy Policy
further governs the use of the information you provide. By providing the information and selecting the Register Next button, you indicate that you read, understand, and agree to these terms.
Organization Information
Organization NPI
*
Organization Name
*
Address 1
*
Address 2
City
*
State
*
-- Select One --
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
Zip
*
Phone Number
*
Fax Number
Administrator Information
User Type
*
Prescriber
Practice Coordinator
NPI Number
*
First Name
*
Last Name
*
Email Address
*
Confirm Email Address
*
User Name
*
Password
*
Confirm Password
*
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Actelion Pathways
is not functioning as my business associate and have taken that fact into consideration in determining what patient "authorization is necessary"
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