Provider Contact Information     
 
 

Updated Contact Information for Providers

The aftermath of Hurricane Katrina has affected a number of the people Humana touches every day. We want to be sure we have the most recent information should we need to contact you. Please take a moment and fill out this form. Please call 1-866-427-7478 or 920-337-5090 if you have other questions.
Previous Information
First Name:* *
Last Name:* *
Practice Name:
Address:
City:
State:
Zip:
Office Phone:
Email Address:
Fax Number:
Current Information
First Name:* *
Last Name:* *
Practice Name:
Billing or Service
Address:		 BillingServiceBoth
Address:
City:
State:
Zip:
Office Phone:* *
Email Address:* *
Please select the best contact method:
Phone
Email
Fax Number:
Other contact information:

* Required (a phone number or an email address is required)

 
 

 

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