Empanelment

Welcome to NLGIC Medical Service Provider empanelment. Please fill in the below details to empanel as a service provider :

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Name of the medical service providerName of the medical service provider

Phone NoPhone No

Contact Person Name and DesignationContact Person Name and Designation

GSMGSM

Emaila valid email

Services Offered and locations where present

Fileupload

Upload File

Copy of Ministry of Health License

Fileupload

Upload File

Upload your CR Copy

Fileupload

Upload File

Company Brochure

Fileupload

Upload file

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