COMPdata Informatics

New/Update Facility Account Information

Facilty Type:

Check one:

If yes, provide the former facility name below
Provide the full business name
Provide your facility NPI to associate file submissions to this new account
Reporting an NPI Change:

Provide any additional NPIs that your data will be submitted under. Separate multiple NPIs with a /
Submission will begin :

Provide follow up contact information
Provide any additional information or questions