WellSpan Chambersburg Hospital, WellSpan Waynesboro Hospital, WellSpan Roy A Himelfarb Surgery Center, and WellSpan Cumberland Valley Health Network (PHO)
At WellSpan Health, we are committed to providing excellent, affordable care to build a healthier and stronger community. The Provider Resources team is dedicated in assisting the organization with achieving excellence and helping you successfully complete the credentialing process.
Provider Credentialing Request
Provider Information Change
Form used to communicate any changes for provider
Provider Termination Form
Form used to communicate any termination from a group, facility/entity.
Group Information Change
Form used to communicate group changes.
Hospital Affiliation Verification Letters
Medical Staff Dues
Note: Failure to submit any of the applicable required documentation will result in delay of your hospital credentialing and insurance enrollment.
Emergency Medicine (Hospitalists - Neurologists)
Surgical Staff (Anyone working in the Operating Room)
Medical Staff Bylaws
** Proposed ByLaws Changes **
Bylaws Revisions for Vote
MAP 174 - System Credentialing Policy
For additional help or information:
Call (717) 267-7180 | Fax (717) 267-4806 | E-mail firstname.lastname@example.org