EZ-NET™ Login

New User Registration

*Required

* E-Mail :

We recommend using your email address with out the domain
name,i.e user@yourdomain.com would be user.The user name
field will automatically be populated with the first part of
your email address,but may be changed at any time.

* User Name :

* Password :

* Confirm Password :

First Name :

* Last Name :

Title :

Department :

* Phone Number :

Fax :

* User Type :

* Company(s)

	Available Company(s)

	ALIGN SENIOR CARE VA	H1277
	AGERIGHT ADVANTAGE	H1372
	GREAT PLAINS MEDICARE ADVANTAGE SD	H1787
	LIFEWORKS ADVANTAGE	H2185
	ALIGN SENIOR CARE CALIFORNIA	H3274
	PERENNIAL ADVANTAGE OF CO	H3419
	PROCARE ADVANTAGE	H3467
	SUNRISE ADVANTAGE PLAN OF NY	H3930
	SIMPRA	H4091
	NHC ADVANTAGE	H4172
	SUNRISE ADVANTAGE PLAN OF PA	H4236
	SUNRISE ADVANTAGE PLAN OF IL	H4778
	PRUITTHEALTH PREMIER OF CAROLINAS	H6345
	ALIGN SENIOR CARE MI	H6832
	KEYCARE ADVANTAGE	H6959
	GREAT PLAINS MEDICARE ADVANTAGE NE	H7511
	SUNRISE ADVANTAGE PLAN OF VA	H7802
	PERENNIAL ADVANTAGE OF OH	H8797
	GREAT PLAINS MEDICARE ADVANTAGE ND	H8967
	LONGEVITY HEALTH PLAN OF OK	H9095
	ALIGN SENIOR CARE OF FL	H9917
	PRUITTHEALTH PREMIER	PHP

	Selected Company(s)

* Company(s) :

* Provider(s)

Provider NPI:

Provider Tax ID:

Last Name:

First Name:

	Provider Name	Provider ID	Company ID

	Provider Name	Provider ID	Company ID

* Vendor(s)

Vendor ID:

Vendor Name:

	Vendor Name	Vendor ID	Company ID

	Vendor Name	Vendor ID	Company ID

* Facility(s)

Facility ID:

Facility Name:

	Facility Name	Facility ID	Company ID

	Facility Name	Facility ID	Company ID

Type the letters you see in the below picture

* Captcha :

Copyright© 2006-2018 Citra Health Solutions. All Rights Reserved. System availability, transaction execution,
and response times may vary due to volume, system performance and other factors.Technology provided by Citra Health Solutions.

EZ-NET v6.6.3