Pharmacy Help Desk: 1-877-209-1264, Provider PA Help Desk: 1-877-207-1126

Provider Enrollment

All pharmacy providers are required to fill out and sign all forms within the Wyoming Medicaid Pharmacy Provider Enrollment Packet. If you currently provide pharmacy services (excluding DME) to Wyoming Medicaid clients or plan to provide services in the immediate future, you must complete the Pharmacy Provider Enrollment Packet.

Click on the link below to download a PDF version of the Enrollment Packet. Provider enrollments are approved and denied by the Wyoming Department of Health, Pharmacy Services.

Pharmacy Provider Enrollment Packet

If you would like to receive a packet via mail or email or have questions, please call Change Healthcare at 877-205-8083 or email Change Healthcare at

* DME Pharmacy Providers must submit a separate enrollment packet to Xerox, the Wyoming Medicaid DME Fiscal Agent. You can contact Xerox at (800) 251-1268.

* If your pharmacy employs pharmacists who are certified immunizers, those individuals must enroll with Wyoming Medicaid since they are considered the “prescribing provider” on immunization claims. Enrollment is necessary in order to avoid denial of immunization claims in the future. If the “prescribing provider” on the claim is not enrolled with Wyoming Medicaid, the claim will deny for payment. The process of enrolling pharmacists is being handled by Xerox who can be contacted at (800) 251-1268 (options 2, 1, 2 to speak to an agent). Web enrollment may be completed at the following website: