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Get When You Contact Blue Cross Of California (BCC) With ... - Anthem

Tamanagementservices wellpoint.com EAP Practice Changes EAP Fax: 888-438-7957 EAPProviderNetworks anthem.com Instructions: 1. 2. 3. 4. Address information should correspond to only one Tax Identification Number (Tax ID) per form. A W-9 is required when replacing/adding a Tax ID. Complete an additional form if there are other addresses associated with the Tax ID that cannot be listed below. Complete the entire form. E-mail or fax the completed form to the appropriate Network D.

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