Warning: Your Web Browser is outdated and may not be compatible with many features of this site. Click Here to Learn More
For individuals using screen readers or similar accessibility aids, click here to skip the header and main navigation.

EDI New Account Form

This form is for agencies to notify OBM of new EDI account numbers
once the account has been established with the vendor.

   
Name: *  
Agency: *  
Email: *  
Phone: *    
New Account Number: *  
OAKS Supplier #: *  
Origin Code:  
     
   
   

For individuals using screen readers or similar accessibility aids, click here to return to the top of the page.