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ModivCare fax number
(877) 601-0535
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Facility Enrollment / Provider Enrollment
Used for: Submitting facility enrollment forms for ModivCare's Non-Emergency Medical Transportation (NEMT) services (e.g., Medi-Cal/CHPIV provider enrollment).
Fax destination details
- Department
- Facility Enrollment / Provider Enrollment
- Purpose
- Submitting facility enrollment forms for ModivCare's Non-Emergency Medical Transportation (NEMT) services (e.g., Medi-Cal/CHPIV provider enrollment).
- Form
- Enrollment form — ModivCare Enrollment Form
- Address
- 6900 East Layton Avenue, Denver, CO 80237, USA
- Voice phone
- 866-529-2128
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Print the enrollment form from ModivCare's website and fax it to 877-601-0535 to enroll as a provider for NEMT services.
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