Interested in becoming a supplier for Advantus Health Partners?

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Phone

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Supplier Identification Details

Fill out all the information as it applies to your business.

Supplier Name*

Other Legal Names

Number of Employees

Tax ID

Location Name (Corporate preferred)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Contact Person*

First Last

Primary Contact Email*

Primary Contact Phone*

Primary Contact Title*

Website

Please select the product / service categories you are interested in providing.*

Do you have the capacity to support multi-site hospital systems?*

Yes

Please comment on any capacity limitations or product/service availability.

Does your company, or any other business unit within your parent company already have a contract with Advantus Health Partners or its parent company, Bon Secours Mercy Health (BSMH)?*

Yes

If yes, what supplies or services do you provide?

How did you hear about Advantus Health Partners or BSMH?*

Supplier Certifications

Government Classification:

NAICS Codes separated by commas

What is the primary ownership status? (e.g. socially disadvantaged background - geography, protected characteristic, veteran status, etc.)

Is the business certified by a third-party organization (e.g., WBENC, NMSDC)?*

Yes

If yes, please provide the certification number and issuing agency.

Does the business have any other relevant certifications or affiliations?

Please provide a copy of certifications with form submission

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Accepted file types: pdf, jpg, png, doc, docx, Max. file size: 50 MB.

(888) 383-8000

Call: (866) 954-6247

Supplier Identification Details

Supplier Certifications