Enroll In Network
We would like you to be a part of our Provider Network. To empanel your hospital, please fill this provider enrollment request form completely and accurately.
Basic Detail
Address Details
Communication Details
Details
Additional Information
Bank Account Details
ACCREDIATION & CERTIFICATION Details
Note:
  • All fields marked with * are mandatory
  • The submission of this form in no way guarantees the empanelment on PHS network
  • As per IRDA Regulations, cashless facility will be provided only to those hospitals that have valid ROHINI registration ID.
    After registration, kindly share your ROHINI ID with Paramount.