Patient's Home Address:
PAN's travel programs have a minimum mileage requirement. The requirement is a minimum mileage distance of 20 miles (one way) from the patient's home to the treatment facility. Certain metropolitan areas have a minimum mileage distance of 5 miles.
Your treatment facilities
|Treatment Facility||Address||City||State||ZIP||Distance from home||Action|
Please attach copy(ies) of your appointment schedule.
No matching providers were found, please revise your search and try again. For assistance, please contact our call center at 1-866-316-7263.
Please select the treating/prescribing provider from the list below. If more than one provider is associated with the patient's treatment, select the primary provider:
|First Name||Last Name||NPI||Organization||Address||City||State||ZIP|
Only first 100 records are displayed in the search results. Please refine your search to narrow the results.