Provider Enrollment

If you are interested in participating in the PA-SIIS, please complete the provider interest form.

After you have completed and submitted the provider interest form, a PA-SIIS staff member will contact you to schedule a meeting and establish an implementation data.

Contact Us

Contact:

Bureau of Health Statistics and Research

Address:

555 Walnut St, 6th Floor
Harrisburg, PA 17101-1914

Phone:

(717) 783-2548

FAX:

(717) 772-3258

Email:

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