Provider Payee Number Renewal Form

RENEWAL REMINDER OF PROVIDER NUMBERS

TO:  ALL SERVICE PROVIDERS

All Service providers affiliated with AHFoZ are reminded to kindly renew their Provider numbers.  Please complete the attached form in full and return to this office by no later than 31 March , together with:

  • a photocopy of your current practising certificate
  • Health Professions Authority (HPA) premises certificate (if applicable)
  • Medicines Control Authority of Zimbabwe (MCAZ) premises and persons licenses (if applicable)

Failure to renew by that date will result in the withdrawal of your Provider number as it will be assumed that the number is no longer in use. No renewal fees are being charged.

NB: AHFoZ is currently carrying out trainings on ICD10 Coding. Kindly     contact us on the above details for further information.

PERSONAL DETAILS

Step 1 of 4

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  • Title
  • Initials






  • ID Number
  • Practicing Certificate No.
  • Expiry Date
  • Dispensing License No.
    (if applicable)
  • Effective Date
  • Expiry Date