Attn: Intense Medical Case Management Unit
1006 Hemlock Drive
Willow Oak Building - DGS Annex Complex
Harrisburg, PA 17110-3595
Phone: 1-800-537-8862 or 717-772-6777
Fax: 717-265-8030
For questions regarding the form contact:
Attn:Intense Medical Case Management Unit
Commonwealth Towers
303 Walnut Street, 9th Floor
Harrisburg, PA 17101
Phone: 1-800-537-8862
Fax: 717-705-8391
8040 Carlson Road, Suite 500
Harrisburg, PA 17112
Phone: 1-888-208-9528
Fax: 1-855-809-9205
901 Market Street, Suite 500
Philadelphia, PA 19107
Phone: 215-967-4690
Fax: 215-967-4492
2000 Market Street, Suite 850
Philadelphia, PA 19103
Phone: 215-282-3521
Fax: 877-683-7354
Four Gateway Center
444 Liberty Avenue, Suite 2100
Pittsburgh, PA 15222-1222
Phone: 1-800-392-1147
Fax: 1-888-225-2360
200 Stevens Drive
Philadelphia, PA 19113
Phone: 1-800-521-6867
Fax: 1-877-353-6913
100 North Academy Avenue
Danville, PA 17822-3220
Phone: 570-271-5108
Fax: 570-214-1583
2 Allegheny Center, Suite 600
Pittsburgh, PA 15221
Phone: 1-800-599-5985
Fax: 1-877-353-6913
8040 Carlson Drive, Suite 500
Harrisburg, PA 17112
Phone: 1-877-364-6797
Fax: 1-866-755-9935
U.S. Steel Tower 37th Floor
600 Grant Street
Pittsburgh, PA 15219
Phone: 1-866-778-6073
Fax: 412-454-8558