Enter your assigned Tracking Number, Tax ID and Password in order to resume an existing provider enrollment application. For further questions, please feel free to contact Gainwell's Provider Enrollment Department at 1-888-223-3630 (in state) or (334) 215-0111 (out of state).

Please be aware that Gainwell's Provider Enrollment Department is not privy to and cannot provide to you nor reset the information you need to enter on this page in order to resume an existing application.

Note: For OPR Enrollments the provider’s SSN (Social Security Number) must be entered where the Tax ID is required.