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Franklin & Cumberland Counties

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

Initial Applications

Note: Failure to submit any of the applicable required documentation will result in delay of your hospital credentialing and insurance enrollment.

Application Fee:

Emergency Medicine (Hospitalists - Neurologists)

Radiation Safety

Surgical Staff (Anyone working in the Operating Room)

Education

Forms

Proposed Bylaws

Provider Opportunities

For additional help or information:
Call (717) 267-7180 | Fax (717) 267-4806 | E-mail smt-shcvo@wellspan.org