Vendor Number Updates


 * required  
Have you previously provided service to ICBC and know your account?
Yes No *
May start with a letterhelp text Account Number *
Regarding your ICBC vendor account, what information do you need to update? *
(You may select more than one)
Vendor Information
Address
Tax Information
General Information
Payment Method
Services Provided

Vendor Information
Legal Name *

Address
Address *
City *
Postal Code *
Country *
PO Box

Tax Information
GST Number *
Are you billing as a clinic or as an individual health care provider? *
Clinic - all services provided by all disciplines will be billed and paid under this number
Physician or Individual Health Care Provider - Services will be billed and paid directly to the Physician or Individual Health Care Provider

GST Number

Clinic Information
Legal Name *
Legal Name 2
The operating name of a company, as opposed to the legal namehelp text Operating name
GST Number
Does your company gross over $30,000K per Fiscal year?
Yes No *
Address *
City *
Postal Code *
Country *
PO Box
Phone Number *
Email for reply to this submission *

General Information
Does your company gross over $30,000K per Fiscal year?
Yes No *

Payment Method
How do you want to be paid? *
Cheque - payment and statement sent via Canada Post
EFT - Payment and Statement sent electronically
Email address
(to receive a confirmation email)		 *
Services Provided
1
Add  Remove  *
Health Care Provider Type *
Health Care Provider First Name
Health Care Provider Last Name
Health Care Provider or Association Number
  Add another Service

Email for reply to this submission *