Home Broker/Consultant Provider Member Employer Payor Need Coverage Facility Search Physician Search Directory Request Sign In Health Education About AFMC AFMC Guide Benefit Protect VentureNet Healthcare     Arizona Foundation for Medical Care 326 E. Coronado Rd. Phoenix, AZ 85004   800-624-4277 602-252-4042 Printable contact list with fax numbers Provider Nomination  If your provider is not already participating with the Arizona Foundation for Medical Care and you would like us to contact your provider’s office to see if they will join our network, please complete the following information: *Indicates a required field. Tell us about your provider: *First Name *Last Name Degree Specialty Practice Name *Practice Phone Practice Address: Street *City State      Zip   Tell us about yourself: Your Name Your Phone Your Email            Career Opportunities | Contact Us | News Releases Media Contacts | E-PHI | Privacy Notices | Terms and Conditions Copyright © 2008 Arizona Foundation for Medical Care All rights reserved. Reproduction in whole or in part without permission is prohibited.