list provider indemnity update per 31 juli 2015 …inhealth.co.id/uploads/list provider...
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No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
DENPASAR
1 0870 RSU. KERTHA USADA JL. CENDRAWASIH, NO.57, SINGARAJA
BPK.PUTU
WILANTARI /SYLVIE
YULIASARI B.BUS
MARKETING 0362-26277/8| 0362-22741 Y Y Y ACTIVE ALL COVERAGE [email protected]
2 1451 RSU. PARAMA SIDHI JL. A.YANI NO.171ABPK. DERMAWAN/
IBU SUCIMARKETING 0362-29787, 32701,22426,| 0362-29787 Y Y Y ACTIVE ALL COVERAGE [email protected]
DENPASAR
3 1047 RS. BALI MEDISTRA ( BALIMED )JL. MAHENDRADATTA, NO.57X,
DENPASARBPK KRISNA Marketing
0361-484748,
482281,8450771, 8450772|
0361-
8450773,8450770Y Y Y ACTIVE ALL COVERAGE
marketing_balimedhospital@yah
oo.com
4 0864 KLINIK & APOTEK KF 34 DENPASAR JL. DIPONEGORO NO.125, DENPASAR BPK WISMAYA KOORDINATOR 0361-225555/227811-12-|- 0361-223433 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
5 3455APOTIK KIMIA FARMA NO.66
PATIMURAJL. PATIMURA NO.59 DENPASAR - - 0361-234797| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
6 2599 KLINIK & APOTEK KF 82 JL. KARTIKA PLAZA, NO.67, KUTA-BALIDRS. SANGKAN
MULYANTO ,APT- 0361 757196| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
7 2600 KLINIK & APOTEK KF 236JL. DANAU BATUR RAYA, TM GRIYA,
JIMBARAN
DRS. AJI
PAMUNGKAS,APT- 0361 8479785| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
8 1150 RSIA. PURI BUNDA JL. GATOT SUBROTO VI, NO.19 IBU ONI / LIRA MARKETING 0361-437999| 0361-433988 Y Y Y ACTIVE ALL [email protected]/dek_onik@
yahoo.co.id
9 1245 RSU. SURYA HUSADHA UBUNGJL. COKROAMINOTO, NO.356,
DENPASARKARMILA DEWI MARKETING 0361-425744| 0361-430557 Y Y Y ACTIVE ALL COVERAGE -
10 1202KLINIK MERDEKA MEDICAL CENTER
(MMC)
MERDEKA VIII/2 TANJUNG BUNGKAK-
DENPASARI KETUT SUSANA - 0361-233790| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
11 1273 RS. SURYA HUSADHA JL. PULAU SERANGAN,NO.7, DENPASAR KARMILA DEWI MARKETING 0361-233787| 0361-231177 Y Y Y ACTIVE ALL COVERAGEmarketingsuryahusadha@gmail.
com;
12 1309 BALI ROYAL HOSPITAL ( BROS ) JL. TANTULAR NO 6 RENON DENPASAR IBU LILIK SHANTINI MARKETING 0361- 247499/222588|0361-
226051/226052Y Y Y ACTIVE ALL COVERAGE [email protected]
13 1146 RSU. BHAKTI RAHAYU DENPASAR JL. GATOT SUBROTO II, NO.11 BPK BAGUS MARKETING0361-
430270,430245,7420673|0361-263371 Y Y Y ACTIVE ALL COVERAGE [email protected]
14 1463 KLINIK PENTA MEDIKAJL. TEUKU UMAR BARAT-
MARLBORO,NO.88DR.SATRY WIBAWA CLINIC MANAGER 0361-7446144/490709| 0361 - 490708 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected]/billing
@pentamedica.com
15 0220 RS. PRIMA MEDIKA JL. PULAU SERANGAN, 9X DR.DIAN EKAWATI MARKETING 0361 - 236225/257445|0361-
236203/262535Y Y Y ACTIVE ALL COVERAGE
om
16 0179 RSU. KASIH IBU DENPASAR JL. TEUKU UMAR, NO.120 IBU EKA MARKETING
0361-
223036/3003030/08214680
6677|
0361-238690 Y Y Y ACTIVE ALL COVERAGE [email protected]
17 0140 RS. MANUABA JL. HOS. COKROAMINOTO, NO.28BPK. GEDE / IBU
LODEKEUANGAN 0361-426393|
0361-
285183/429447Y Y Y ACTIVE ALL COVERAGE
[email protected]/manua
18 0221 RS. PURI RAHARJAJL. WR.SUPRATMAN, NO.14-19,
DENPASARIBU.I NYOMAN MARKETING 0361-222013| 0361-242537 Y Y Y ACTIVE ALL COVERAGE [email protected]
19 0867KIMIA FARMA HEALTHCARE -
DENPASARJL. DIPONEGORO NO.125, DENPASAR
IBU NI KADEK
BAGIANIKOORDINATOR 0361-255914-|- 0361-255914 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
GIANYAR
20 1761 RS. ARI CANTI GIANYAR JL. RAYA MAS UBUD GIANYAR DR. IKA / NGURAH MARKETING 0361-974573| 0361-974573 Y Y Y ACTIVE ALL COVERAGE [email protected]
21 3549 RSU. SANJIWANI GIANYAR JL. CIUNG WANARA N0.2 GIANYAR WAYAN KASUBID UMUM 0361-943049| Y Y Y ACTIVE ALL COVERAGE [email protected]
22 4075 RSU. PREMAGANA
JL. HAYANG SANGSI NO.2 PERUM
CHANDRA AYU, BANJAR TUBUH, BATU
BULAN - SUKAWATI
AGUNG BRAHMA /
KADEKMARKETING
0361-296328/ 296389 /
082144049401|0361-295246 Y Y Y ACTIVE ALL COVERAGE [email protected]
KARANGASEM
23 2301 KLINIK PENTA MEDICA CANDIDASAJL. RAYA MANGGIS NO. 88, KAB.
KARANGASEM, BALIBPK DEDI - 0363-41909| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
24 4252 RS. BALIMED KARANGASEMJL. NENAS KECICANG BEBANDEM,
KARANGASEM, BALI
CRISTIN CAROLINA
(082236282821- (0363) 4301618| Y Y Y ACTIVE ALL COVERAGE
marketing.rsbalimedkarangasem
@gmail.com
KLUNGKUNG
25 1893 RS. BINTANGJL. NGURAH RAI NO. 36 KLUNGKUNG -
BALIIBU ARI MARKETING 0366-25241| - Y Y Y ACTIVE ALL COVERAGE -
KUTA
26 1492 KLINIK KASIH IBUKOMPLEKS PERUM BUMI DALUNG
PERMAI, BLOK C1-C4IBU PUTRI/YANTI MARKETING 0361-422150| 0361-422179 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
27 1138 RSU. KASIH IBU KEDONGANAN JL. ULUWATU, NO.69A, KEDONGANAN IBU FRISA MARKETING 0361-703270| 0361-703329 Y Y Y ACTIVE ALL COVERAGEfrisa.andarina@kasihibuhospital.
com
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 1 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI28 0875 KLINIK MANUABA JL. RAYA KUTA - TUBAN DR.FAJAR MANUABA KOORDINATOR 0361-754748| 0361-227228 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected]/manua
29 1909 SILOAM HOSPITALS BALI JL. SUNSET ROAD NO. 818, KUTA IBU NETTY Marketing 0361-779900| 0361-779933 Y Y Y ACTIVE ALL [email protected]
om
NUSA DUA
30 1359 RSU. SURYA HUSADHA NUSA DUA JL. SILIGITA, BLOK 1, NO.14 KARMILA DEWI MARKETING 0361-775827| 0361-771388 Y Y Y ACTIVE ALL COVERAGE -
31 2603 KLINIK & APOTEK KF 126JL. BY PASS NGURAH RAI NO 890,NUSA
DUA
DRS. AJI
SUTARMAJI,APT- 0361 778555| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
32 0222 KLINIK PRIMA MEDIKAJL. BY PASS NGURAH RAI, PERTOKOAN
NIAGA, NO.81
IBU LUH GEDE
DARWATIKOORDINATOR 0361-770509| 0361-770509 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
SANUR
34 1248 KLINIK REMEDIUM CARE JL. BY PASS NGURAH RAI NO.243 IBU DELLA DIREKTUR 0361-288860| 0361-287970 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
TABANAN
35 1714 RS. WISMA PRASANTIJL. YAH GANGGA NO. 9 TABANAN ,
BALI
BPK AGUNG MAYUN/
DR. IGE RAY WIJAYA
MARKETING/Direkt
ur0361-8043219/810555| 0361-812454 Y Y Y ACTIVE ALL COVERAGE [email protected]
36 2133 RSU. KASIH IBU TABANANJL. FLAMBOYAN NO. 9 ( KAMPUNG
KODOK )DR. BOANA MARKETING 0361-3005757| 0361-3005758 Y Y Y ACTIVE ALL COVERAGE [email protected]
37 3456APOTIK & KLINIK KIMIA FARMA.102
TABANANJL. NGURAH RAI NO.74 A TABANAN - - 0361-810524| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
UBUD
38 0224 UBUD CLINICJL. TJAMPUHAN, NO.36, P.O.BOX 10,
UBUD, GIANYAR
DR.I.WAYAN
SUANDHI ARYANA/
AGUNG
KOORDINATOR 0361-974911| 0361-974910 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
BANGKA INDUK
39 2148 RS. ARSANIJL. RAYA AIR KENANGA KEC. SUNGAI
LIAT KAB. BANGKA BLITUNGIBU IRNA RAWATI MARKETING 0717-4297825, 4297834| 0717-4297824 Y Y Y ACTIVE ALL COVERAGE [email protected]
BELITUNG
40 1928 KLINIK UTAMA BELITUNGJL. MERDEKA NO. 27 TANJUNGPANDAN
BELITUNGIBU ETA MARKETING 0719-25526| 71925600 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PANGKAL PINANG
41 1443 RS. KHATOLIK BHAKTI WARA JL. SUNGAI SELAN, KM.4, NO.180 BPK.OCTAVIANUS Marketing 0717-422605| 0717-424314 Y Y Y ACTIVE ALL [email protected];rsk_
42 1508 RS. MEDIKA STANNIAJL. JEND.SUDIRMAN, NO.3, SUNGAI
LIAT
IBU LIA/ BP BUDI/
IBU RIDAADMINISTRASI 0717-95837/93335| 0717-953335 Y Y Y ACTIVE ALL COVERAGE [email protected]
43 0900 SUN CLINICEL-JOHN PLAZA, JL. SUKARNO HATTA,
NO.208DIAH KOORDINATOR 0717-4297888-|- 0717-439488 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
44 1230 RS. BAKTI TIMAH PANGKAL PINANGJL. BUKIT BARU NO.1 PANGKAL
PINANGBP HERI MARKETING 0717-421091| 0717-424212 Y Y Y ACTIVE ALL COVERAGE
CILEGON
45 0995 KLINIK & APOTIK WARINGINJL. RAYA WARINGIN KURUNG SERDANG
SERANGDR MONITA / DIANA koordinator
0254-
310609/085215480711-|-- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
46 1943 KLINIK MUTIARA BUNDA JL. S.A TIRTAYASA NO. 86, CILEGON - - 0254-399968|0254-
399989/376454N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
47 1815 KLINIK INSAN PRIMARUKO CILEGON CITY SQUARE BLOK I-8,
CILEGONDRG. LUSI Owner 0254-393 197| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
48 2780 KLINIK GRIYA SEHAT
PERUMAHAN GRIYA CILEGON BLOK D6-
7 KEL.WARINGIN KURUNGI,
KEC.KRAMATWATU 42161
DR.RETNO Pemilik/Finance 0254-388501| 0254-388501 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
49 4327 KLINIK ISNA MEDIKA
JL. RAYA MERAK KM.8 KESERANGAN
KEL. RAWA ARUM KEC. GROGOL,
CILEGON, BANTEN
- - 0254-573756| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
50 0915 RS. KRAKATAU MEDIKA JL. SEMANG RAYA - CILEGON IBU YATI MARKETING0254-3963330254-
372123|0254-372123
0254-
391972/374010Y Y Y ACTIVE ALL COVERAGE
[email protected]/ruhiyat@rskmd
.com
51 0939 RSIA. MUTIARA BUNDA CILEGONJL. SA TIRTAYASA RUKO MAISONETTE
BLOK B 1-2 SIMPANG TIGA CILEGONBPK.RIFAI MARKETING
0254-
399988/376888/399968-|-0254-376454 Y Y Y ACTIVE ALL COVERAGE
d/@ymail.com
52 0121 KLINIK AMALIA JL. S.A TIRTAYASA NO.7BPK MAKHBUD
NAHDIADMINISTRASI 0254-391307-|- 0254-391307 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
BANGKA BELITUNG
BANTEN
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 2 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI53 0057 KLINIK ALFINA
RUKO PONDOK CILEGON INDAH, BLOK
KK1, NO.7-8BIDAN ATUL/ERNA KEUANGAN 0254-383116| 0254-377377 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
54 0129 APOTIK LABORA FARMA JL. ALUN-ALUN UTARA, NO.23DR. BUI MIN / DR.
MERRY CHANDRAKEUANGAN 0254-391695| 0254-374278 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
55 2335 KLINIK EDI MEDIKARUKO EDI TOSERB. A, JL. RAYA MERAK
88 CILEGON, BANTEN 42431IBU DIAN KOORDINATOR 0254-383080| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
56 0951 KLINIK & APOTEK KF 140 JL. S.A. TIRTAYASA NO 12 DR AGUS CAHYANA KOORDINATOR 0254-392278-|- 0254-399173 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
57 0985 RSIA. KURNIA CILEGON JL. JOMBANG MASJID NO.4 IBU.TRI MARKETING 0254-391161|-0254-
396489,397023Y Y Y ACTIVE ALL COVERAGE
58 1254 RB & KLINIK AFINAJL. RAMBUTAN 12, PAGEBANGAN -
CILEGONIBU DESI PENGELOLA 0254-392568| 0254-392568 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
59 1403 KLINIK KELUARGA PULO AMPELJL. SALIRA INDAH DS.SUMURANJA
PULOAMPELDR. RACHMI Pimpinan
0254-5751100 / 0254 -
572100|0254-5751100 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
60 1536 KLINIK & APOTIK KOTA BAJA JL. S.A. TIRTAYASA, NO.115BPK.SYAHRIZAL/IBU
OPIKOORDINATOR 0254-391822|
0254-
392346/391822N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
61 1298 KLINIK IKHLAS MEDIKA IVPONDOK CILEGON INDAH ( PCI ) BLOK
A 19/10 CILEGONDR. TETI ENDRIANI - 0254-7061935| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
62 0302 KLINIK ANANDA CILEGON JL. R. SUPRAPTO KM.8DR. MOCH.
PROKOSOKEUANGAN 0254-310609| 0254-310821 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
63 0320 KLINIK BONA MEDIKAFESTIVAL RUKO, BLOK B10-11,
BONAKARTADRG. ANE MARKETING 0254-387684| 0254-386699 N Y Y ACTIVE ALL COVERAGE [email protected]
64 0595APOTIK & KLINIK PRIMA HUSADA
CILEGON
RUKO CILEGON CITY SQUARE (
SAMPING GIANT-PCI) BLOK B3;5 E3;5IBU IDA
MARKETING/KEUA
NGAN
0254 - 399933/3998560254
- 391677|0254 - 3916770254-399928 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PANDEGLANG
65 1764 KLINIK ALFURQONJL. RAYA LABUAN KM 2 TOROGONG
MARGASANA - PANDEGLANG
IBU ELIS / DR
FURQON
KEUANGAN /
PEMILIK0253-803777| 0253-501313 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
66 0997 KLINIK DIFFAJL. RAYA LAB. UAN KM.12 CIPUTRI
MENESBPK DIDI/ HERRY PEMILIK/ADMIN 0253-502161-|- 0253-502160 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
RANGKASBITUNG67 1084 RS. MISI LEBAK JL. MULTATULI NO.41 IBU YENI MARKETING 0252-201014-|- 0252-203390 Y Y Y ACTIVE ALL COVERAGE [email protected]
68 0658 KLINIK SEHAT RABINZAJL. HADIWINANGUN, PERTOKOAN
RABINZA, BLOK B1-2IBU MURTINI KOORDINATOR 0252-280023| 0252-280023 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
69 3141 KLINIK DAN APOTEK MEDIKAJL. AHMAD YANI RANCASEMA -
RANGKASBITUNG, BANTENDR. DIANA - 0252-209975| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
SERANG
70 2413 KLINIK ANDRI MEDISTRAJL. N. RAYA SERANG JAKARTA KM 8
CIRUAS, SERANG - BANTENDR. ANDRI PEMILIK -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
71 2726 KLINIK & APOTEK KF 253JL. YUSUF MARTADILAGA NO. 114
SERANG- BANTEN- - 0254-211447| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
72 2414 KLINIK JANNAHJL. KH.ABDUL HADI NO.13 KEBUN JAHE
SERANG, KAB.BANTENDR JANNAH - 0254-209321| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
73 3993 RS. KURNIA SERANGJL. RAYA CILEGON KM.8, DESA
KRAMATWATU SERANG - BANTENIBUTRI RAHMISIVA - 0254-232648| 0254-8235050 Y Y Y ACTIVE ALL COVERAGE [email protected]
74 3985 KLINIK & APOTEK MURASAKI MEDIKAKOMP.PEJATEN MAS BLOK C/1 PEJATEN
KEC.WATU-BANTENDR.WARIH ANJANI - 0254233317| - N Y Y ACTIVE ALL COVERAGE [email protected]
75 2392 KLINIK & APOTIK BONA SERANGJL. RAYA SERANG - CILEGON RUKO
LEGOK SUKMAJAYA NO. 5A1 SERANGBPK HERI - 0254-228005/ 287684| 0254-205906 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
76 2336 KLINIK TIARA DENTAL
JL. RAYA WARINGIN KURUNG, RUKO
NUSA RESIDENCE KAV.R NO.19 DESA
MARGATANI KEC. KRAMATWATU,
SERANG
BPK AGUS KOORDINATOR 0254-8482203| 0254-5751349 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
77 2608 KLINIK & APOTEK KF SERANG BARU JL. AHMAD YANI NO. 57,SERANGNURUL FAHMI
HAYATI,S.FAR, APT- 0254 211065| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
78 0984 KLINIK CIJAWA MEDIKA JL. KH. A. FATAH HASAN NO.8 DR. L. P. PIRGAYANI KOORDINATOR0254-204735 /
08128521336-|-0254-204735 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
79 1126 KLINIK KRAKATAU MEDIKA SERANGJL. TB SUWANDI, KAV KEMUNING NO. 1
LINGKAR SELATAN KEC SERANGIBU NINA
PENANGGUNG
JAWAB0254-204407| 0254-221397 N Y Y ACTIVE ALL COVERAGE [email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 3 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI80 1414 RSIA. PURI GRACIA
JL. GRIYA PURNAMA NO 99 TEGAL
PADANG LEGOK, SERANG BANTEN
42162
BPK. HANS MARKETING 0254-223333| 0254-223786; Y Y Y ACTIVE ALL COVERAGE [email protected]
81 1272 RS. SARI ASIH SERANGJL. JEND.SUDIRMAN, NO.38,
PENANCANGAN, CIPOCOK
BPK.AGUNG/BPK.SA
HRULMARKETING 0254-220022| 0254-220345 Y Y Y ACTIVE ALL COVERAGE
[email protected]/aramda
82 1489RS. HERMINA CIRUAS (D/H RS.
CITRA MEDIKA CIRUAS
JL. RAYA SERANG KM.9 DS.RANJENG -
CIRUASIBU ENENG Marketing 0254-281829| 0254-281845 Y Y Y ACTIVE ALL COVERAGE
m
83 0716 RSIA. BUDI ASIH JL. K.H. SOHARI, NO.39
IBU HELMI
APRIANTI/ BPK.
ZULKIFLI
MARKETING 0254-212484| 0254-208583 Y Y Y ACTIVE ALL [email protected];
84 0115 KLINIK SERANG MEDIKAJL. RAYA SERANG CILEGON RUKO
LEGOK SUKMAJAYA BLOK 5C NO.1DR. SYAMSIR KEUANGAN 0254-223992| 0254-223992 N Y Y ACTIVE ALL COVERAGE [email protected]
85 1004 KLINIK WISATA MEDIKA JL. RAYA ANYER NO.9DR SUTADI / IBU
ENDANGKOORDINATOR
0254-600933/605141/
081905180805-|-0254-605141 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
86 1008 KLINIK IKHLAS MEDIKA 1KOMPLEK BUMI AGUNG PERMAI 1,NO.
DI/6DR. TETI ENDRIANI
PENANGGUNGJAW
AB0254-207918-|- 0254-281676 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
87 1009 KLINIK IKHLAS MEDIKA 2JL. RAYA SERANG - JAKARTA (DEPAN
KAMPUS UNTIRTA)
DR.TETI ENDRIANI /
BPK AHMAD
PENANGGUNGJAW
AB /ADM0254-284937-|- - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
88 0937 KLINIK MODERN MEDIKA CIKANDEJL. RAYA SERANG KM.68 RUKO B6
CIKANDE SERANGIBU.ARINDA KOORDINATOR 0254-400554-|- 0254-400556 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
89 0941 KLINIK MODERN MEDIKA KRAGILANJL. RAYA SERANG KM15 RUKO D9
KRAGILANIBU AIDA KOORDINATOR 0254-281720-|- 0254-281720 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
TANGERANG
90 0872RB & KLINIK MUTIARA OBBINI
MEDIKA
JL. RAYA KRESEK NO.27, DS.MERAK,
BALARAJABPK BAHTIAR PENGELOLA 021- 59431110-|- 021-59430131 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
91 1014 RB & KLINIK PERMATA - DR JAMILAHJL. NUSA INDAH I, BLOK A7 NO.1,
PERUM. CIBODAS
DR JAMILAH / IBU
LINDAPEMILIK KLINIK 021-5533314| 021-5533314 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
92 1020 RSIA. SELARAS CIKUPAJL. RAYA SERANG KM.18,5 DS BOJONG,
CIKUPABPK ERICK MARKETING 021-5969145/59401289| 021-59401277 Y Y Y ACTIVE ALL COVERAGE [email protected]
93 1025 RS. ARIYA MEDIKAJL. INDUSTRI RAYA 1, BLOK A, NO.1-6,
JATAKEIBU ANI MARKETING 021-5902229/5902232-|-
021-
5902223/5904951Y Y Y ACTIVE ALL COVERAGE [email protected]
94 0936 RS. SARI ASIH CILEDUGJL. HOS COKROAMINOTO NO.38
CILEDUGIBU INDRI/NOVISA MARKETING
021-7333430/ 33553359021-
7332758|021-7332758021-7333441 Y Y Y ACTIVE ALL COVERAGE [email protected]
95 0942 RSIA. MURNI ASIHJL. RAYA BOJONGNANGKA NO 86,
MEDANG, PAGEDANGAN TANGERANG
IMANUEL AGANDA
PURB. ADIREKTUR
021-
36868757/5470263/542009
82/5463672021-
5463755|021-5463755
021-54204504 Y Y Y ACTIVE ALL COVERAGE [email protected]
96 1046 RSIA. PRATIWI JL. RHM NOERADJI, NO.42, KARAWACIDR YUNITA/ BP
NANANGMARKETING
021-5520692/71342783021-
43933978|021-43933978021-5224139 Y Y Y ACTIVE ALL COVERAGE [email protected]
97 1049 KLINIK SELARAS
JL. RAYA SERPONG BSD SEKTOR
IV,RUKO E.NO.43-45 SERPONG-
TANGERANG
IBU YUNIMARKETING/PENA
GIHAN021-5370311-|- 021-5377842 N Y Y ACTIVE ALL COVERAGE [email protected]
98 2337 KLINIK TUMBURJL. PAHLAWAN NO.4 SITUGINTUNG
REMPOA CIPUTAT TIMUR
DRG. ELISABET
SIBURIAN- 0217492818| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
99 2347 RS. PERMATA PAMULANGJL. RAYA SILIWANGI NO. 1A,
PAMULANG TANGERANGRIFIFI MAHESWARI MARKETING 021-74704999/74709079| - Y Y Y ACTIVE ALL COVERAGE
rspermatapamulangmarketing@
gmail.com
100 2609 KLINIK & APOTEK KF BERINGINJL. BERINGIN RAYA NO.45, KARAWACI,
TANGERANG
WIDYOWATI ISTI
KUSUMADEWI,S.FA
RM, APT
- 021 55763538| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
101 2469 KLINIK PRATAMAJL. CIRARAB RAYA NO.61 KEC. LEGOK
TANGERANG - BANTEN- - 021- 54260359| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
102 1646 KLINIK JATI ELOK
KOMP. BUMI JATI ELOK BLOK A I NO 7,
JL. RAYA LEGOK-PARUNG PANJANG KM.
3,MALANGNENGAH, PAGEDANGAN,
TANGERANG, BANTEN
BP BUDI MULYONO MARKETING 021-98496234| 021-5977529 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
103 2504 RS. HERMINA SERPONGJL. RAYA PUSPITEK KM.8 NO.99,
SERPONG, TANGERANG SELATAN-DR DIAN CANDRA marketing (021) 7588 4999| 021 - 75883704 Y Y Y ACTIVE ALL COVERAGE
serpong@herminahospitalgroup.
com
104 2774 RSIA. INSAN PERMATA
JL. BHAYANGKARA 1 NO.68 KEL.
PAKUJAYA, KEC. SERONG UTARA -
TANGERANG SELATAN
PAK SOFYAN - 021-53121344| 021-5396733 Y Y Y ACTIVE ALL COVERAGE [email protected]
105 1168 RSU. BHAKTI ASIHJL. RADEN SALEH, NO.10, KARANG
TENGAH
DRA. SUSI
KURNIASIH / IBU
SUSI
MARKETING021-7305662/63/021-
32575495|
021-
73449491/730565
2
Y Y Y ACTIVE ALL COVERAGE [email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 4 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI106 0971 RS. ISLAM ASSHOBIRIN
JL. RAYA SERPONG KM.11 PONDOK
JAGUNG - SERPONGIBU NENENG MARKETING
021-5384314021-
5374293|021-5374293
021-
5374392/5374294Y Y Y ACTIVE ALL COVERAGE [email protected]
107 1113 MEDIPRO CLINIC CITRA RAYA
JL. BOULEVARD PERUM CITRA RAYA,
RUKO ETERNITY, BLOK KF 01 NO 8-10.
KAWASAN MARDIGRAS
IBU ANDAR MARKETING 021-29003558/9| 021-29003556 N Y Y ACTIVE ALL [email protected]
o.id
108 1116RS. AWAL BROS TANGERANG (D/H
RS. GLOBAL MEDIKA
JL. MH.THAMRIN NO.3 KEBON NANAS -
CIKOKOLIBU PITRI/IBU MERY MARKETING 021-55780888/55781234| 021-55781545 Y Y Y ACTIVE ALL COVERAGE [email protected]
109 1223 EKA HOSPITAL BSDCENTRAL BUSINESS DISTRICT, LOT IX,
BSD CITYIBU. INEZ/ AJI MARKETING 021-25655555| 021-25655544 Y Y Y ACTIVE ALL COVERAGE [email protected]
110 1082 KLINIK TIGA MANDIRIJL. CABE RAYA NO 68D PONDOK CABE,
TANGERANG SELATANIBU SUSI MARKETING 021-7426414/7426366-|- 021-7426414 N Y Y ACTIVE ALL COVERAGE [email protected]
111 1552 BUNDA DALIMA HOSPITALBUMI SERPONG DAMAI, SEKTOR XIV,
BLOK J.11, NO.1BPK.ARI/ISTI MARKETING 021-53154447/8/9| 021-5385062 Y Y Y ACTIVE ALL COVERAGE [email protected]
112 1564 RSB. PERMATA SARANA HUSADAPAMULANG PERMAI, BLOK D3, NO.1-2,
PAMULANGIBU YANI MARKETING 021-7407421/22|
021-
7496346/7407421Y Y Y ACTIVE ALL COVERAGE
[email protected]/psarhu
113 1527 RSIA. TIARAJL. RAYA SERANG, NO.1, KM.4.5,
CIKUPAJIHAD M MARKETING 021-5961999| 021-5960699 Y Y Y ACTIVE ALL COVERAGE [email protected]
114 1528 RB & KLINIK ILANUR JL. RAYA SERANG, NO.1, BALARAJABPK MUSAFA / IBU
MELA
MARKETING/PENA
GIHAN021-5953241| 021-5954473 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
115 1547 KLINIK AMIRAGRIYA LOKA SEK 1.6 BLOK A1 NO.3
BSD, TANGERANG SELATAN
DR.WENNY / BPK
INDRAKOORDINATOR 021-5384219| 021-53164795 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
116 1324 RSIA. CINTA KASIHJL. CIPUTAT BARU RAYA NO.10
CIPUTATBPK GUNAWAN kasir 021 - 74706020 / 7424639| 021 - 74707986 Y Y Y ACTIVE ALL COVERAGE [email protected]
117 1366 KLINIK KARTIKAJL. WR SUPRATMAN NO.25 RENGAS
CIPUTAT TIMUR, TANGERANG SELATANDR DIAN/BP MARDI MARKETING 021-7371987,73881646| 021-73692937 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
118 1455 KLINIK PRADHANARUKO PANORAMA NIAGA NO.14-15
JURUMUDI BARU BENDABPK. BURHANUDIN KOORDINATOR 021-55767587| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
119 1459 KLINIK KARUNIA SEHAT IIJL. PAHLAWAN SERIBU RAYA RUKO TOL
BOULEVARD BLOK B NO.18.BSD CITYDR.MERRY KOORDINATOR 021-53158045| 021-53158046 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
120 1467 RSIA. MUTIARA BUNDA TANGERANGJL. DR. CIPTO MANGUNKUSUMO, NO.3,
CILEDUGBPK. SAIFUL MARKETING 021-7301365/73454951| 021-73454952 Y Y Y ACTIVE ALL COVERAGE [email protected]
121 1471 KLINIK MELIA MEDIKAKOMP. RUKO DUTA GARDEN SQUARE
BLOK C NO 2, TANGERANGDR AULIA - 021-51488219/54370568| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
122 1575 MOM & CHILD CLINICJL. RAYA KELAPA DUA RUKO PDA KAV.
25-29 GADING SERPONG TANGERANGDINI MARKETING
021-54214848 /
083804104440|021-54209393 N Y Y ACTIVE ALL COVERAGE [email protected]
123 1491 RS. HERMINA TANGERANG JL. KS.TUBUN NO.10 PASAR BARU IBU RUTH MARKETING 021-55772525| 021-5582705 Y Y Y ACTIVE ALL COVERAGEtangerang@herminahospitalgrou
p.com
124 1594 RSU. DINDAJL. GALUH NO.2 JATIUWUNG,
TANGERANGIBU.IKO MARKETING 021-55650577| 021-55652149 Y Y Y ACTIVE ALL COVERAGE -
125 1598RS. KARANG TENGAH MEDIKA
(GROUP YADIKA)
JL. KARYAWAN IV, KARANG TENGAH
TANGERANG
BPK DIDIN / BPK
IRFANMARKETING 021-7336699/7335599| 021-7333598 Y Y Y ACTIVE ALL COVERAGE [email protected]
126 1608 RS. SARI ASIH CIPUTATJL. OTISTA RAYA NO. 3 SASAK TINGGI
CIPUTAT, TANGERANG SELATAN
IBU INDRI/ BPK
TRIONOMARKETING 021-7410808| 021-7424445 Y Y Y ACTIVE ALL COVERAGE [email protected]
127 1340 RSIA. KELUARGA KITAJL. RAYA PLP CURUG KM. 4 NO. 8, DS
SUKABAKTI CURUGIBU SISSI MARKETING
021 - 59491011 / 021 -
5986572|
021-
5984991/5982788Y Y Y ACTIVE ALL COVERAGE [email protected]
128 1292 RS. MEDIKA BSDJL. LETNAN SOETOPO KAV. KOM. III A
NO 7, BSD TANGERANGIBU VRINA MARKETING 021 - 5372296| 021 - 5382296 Y Y Y ACTIVE ALL COVERAGE
rsmedika-
[email protected]/vrina_ardina@y
ahoo.com
129 1086 RSU. SARI ASIH SANGIANGJL. RAYA MAUK.KM.3,5 SIMPANG TIGA
SANGIANGBIDAN PRETTY KOORDINATOR 021-5582732-|- 021-55791307 Y Y Y ACTIVE ALL COVERAGE
130 0412RS. PREMIER BINTARO (d/h
RS.INTERNASIONAL BINTARO)
JL. MH THAMRIN NO.1, SEKTOR 7,
BINTARO JAYABAPAK DANI MARKETING 021-745 5500/27625500|
021-748
64854/745 58Y Y Y ACTIVE ALL COVERAGE
marketing@rs-
internasionalbintaro.com;
pringgodani
131 0308 PAMULANG MEDICAL CENTERJL. RAYA PAMULANG BLOK D II/2,
PAMULANGBPK. MEDIARTO MARKETING 021-740 5317|
021-
7497624/7429156N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
132 0610 RSIA. PUTRA DALIMAGRIYA LOKA, SEKTOR 1.2, BLOK UA/26-
27, BUMI SERPONG DAMAIBP. ARI WIDODO MARKETING
021-5380375/5388279021-
5388279 / 53741|021-
5388279 / 53741
021-5381220 Y Y Y ACTIVE ALL COVERAGE [email protected]
133 0007 RS. UIN SYARIF HIDAYATULLAH JL. IR. H. JUANDA, NO.95, CIPUTAT IBU FAIZ/IBU LIA MARKETING 021-7402718| 021-7493532 Y Y Y ACTIVE ALL COVERAGEhumas_rssyarifhidayatullah@yah
oo.co.id
134 0062 KLINIK SARANA MEDIKA BARUJL. RAYA PERUMAHAN KOTA BUMI
KP.TERITI DS.KARET.SEPATANBPK. SOLICHIN KEUANGAN
021-5921153 /
02159372781|021-59308529 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
135 0291 RS. ICHSAN MEDICAL CENTER (IMC)JL. RAYA JOMBANG NO.56 BINTARO
SEKTOR IX, TANGERANGIBU DEWI MARKETING
021-7456379021-
7456386|021-7456386021-7450819 Y Y Y ACTIVE ALL COVERAGE [email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 5 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI136 0696 KLINIK DOKTER KELUARGA MAWAR
JL. KARET RAYA, BLOK 7/69,
PERUMNAS TANGERANG
TINA ,MARTINA DR
BOY
SINATRALUWIYA
ADMINISTRASI021-5525633; 021-
5913616|021-5913616021-5913616 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
klinik-
.id;
137 0344 RS. QADRKOMPLEK ISLAMIC VILLAGE, KELAPA
DUABPK. EMONG MARKETING 021-546 4466| 021-547 0775 Y Y Y ACTIVE ALL COVERAGE [email protected]
138 0064RB & KLINIK 24 JAM DIANA PERMATA
MEDIKAJL. MH. THAMRIN, NO.87C
BPK. ARIEF
RAMADHANKEUANGAN
021-5397314/ 53124105021-
5395312|021-5395312
021-
5394105/5312410Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
om
139 0337 RS. BHINEKA BAKTI HUSADAJL. CABE RAYA NO.17 PONDOK CABE
PAMULANGBPK. ERIK/LILA MARKETING 021-7490018/7490829| 021-7403535 Y Y Y ACTIVE ALL COVERAGE [email protected]
140 0902 RB & KLINIK BUNDA MULYA (H UPEN)JL. SUMANTRI NO. 11 MEKAR MULYA
PARUNG PANJANGIBU UPEN/NURUL PIMPINAN 021-5978058-|- 021-5978058 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
141 0912 KLINIK KARUNIA SEHATRUKO CIKUPA BLOK B NO.21-23,
DEPAN PERUM CITRA RAYA- CIKUPADR.MERRY PENGELOLA 021-5963001-|- 021- 59408388 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
142 0702 KLINIK MAHARANI
BOROBUDUR RAYA NO 152 PERUMNAS
II BENCONGAN KELAPA DUA,
TANGERANG
BPK TONI/BPK
WisnuMARKETING 021-55654096; 5919953| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
143 0285 RS. MELATI JL. MERDEKA, NO.92 IBU UNI MARKETING 021-5523945/55776739|
021-
55769914/552002
8
Y Y Y ACTIVE ALL [email protected];
144 0108 KLINIK PROVITA JL. IR.H.JUANDA NO.125 CIPUTAT IBU DWI KOORDINATOR 021-749 2619| 021-744 0085 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
145 0091MAYAPADA HOSPITAL (D/H RS.
HONORIS)
JL. HONORIS RAYA, KAV.6, KOTA
MODERN/KODYA DATI IIIBU ANI MARKETING 021-5529035|
021-
5529465/5529036Y Y Y ACTIVE ALL COVERAGE
om;any.setyo@mayapadah
146 0022 RS. SARI ASIH KARAWACI JL. IMAM BONJOL NO.38 IBU INDRI MARKETING021-552 2794; 021-
5523239|021-5523239021-5525214 Y Y Y ACTIVE ALL COVERAGE
[email protected]/mkt_rssac@y
ahoo.co.id
147 0733 RS. OMNI ALAM SUTERAJL. ALAM SUTERA BOULEVARD KAV.25
SERPONG - TANGERANGBP.AMRI / YUSAK MARKETING
021-5312 5555/85550711 -
353438|0711 - 353438021-5312 8666 Y Y Y ACTIVE ALL COVERAGE
;
148 0833 RS. BUNDA SEJAHTERAJL. RAYA PURI AGUNG NO 3, KOTA
BARU- PASAR KEMISIBU ZAHRA - 021-5925876/5925889| 021-5925889 Y Y Y ACTIVE ALL COVERAGE [email protected]
149 0844 RSIA. BUNDA SEJATIJL. PRABU SILIWANGI NO.11,
JATIUWUNGIBU NENI MARKETING 021-5900136| 021-5900056 Y Y Y ACTIVE ALL COVERAGE [email protected]
150 0859 RS. AMINAH TANGERANG
JL. HOS COKROAMINOTO (CILEDUG
RAYA) NO.4A KREO SELATAN-
LARANGAN
BAPAK EKO MARKETING021-7371919021-
7371818|021-7371818021-7371333 Y Y Y ACTIVE ALL COVERAGE [email protected]
151 0955DENTAL PREMIER BINTARO ( D/H
DENTAL INTERNASIONAL
JL. MH THAMRIN NO.1, SEKTOR 7,
BINTARO JAYAIBU TRIA
KOORDINATOR
POLIGIGI
021-745 5500; 021-
27625500 ext 1680|-
021-748
64854/745 58N Y Y PARTIAL DENTAL
id
152 0737 RS. USADA INSANIJL. KH HASYIM ASHARI NO.24
CIPONDOH, TANGERANGIBU. WIDA / VERNA MARKETING
021-55752575/5521270021-
55755665/5521272|021-
55755665/5521272
021-55754335 Y Y Y ACTIVE ALL [email protected]/hu
153 1619 RSIA. BUAH HATI PAMULANGJL. RAYA SILIWANGI NO 189 PONDOK
BENDA PAMULANGIBU YUNITA Marketing 021-7414488| 021-7420322 Y Y Y ACTIVE ALL COVERAGE -
154 3791 RSB. CITRA ANANDA JL. RE MARTADINATA NO. 30, CIPUTATIBU DEASY
(081219704760)Marketing (021) 7401347| (021) 7491701 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
155 2744 RSIA. AQIDAHJL. RADEN FATAH NO.40 PARUNG
SERAB, CILEDUG, TANGERANG
AHMAD YUSLI
FARHANDIREKTUR 021 73450244, 7319025| 7310851 EXT.222 Y Y Y ACTIVE ALL COVERAGE [email protected]
156 3047 RSIA. VITALAYAPERUMAHAN PONDOK BENDA INDAH JL.
SILIWANGI NO 1 PAMULANGNUNU NURHAYATI marketing 021-7470 3313| - Y Y Y ACTIVE ALL COVERAGE [email protected]
157 3982 KLINIK & APOTEK KF PALEM SEMI
JL. RUKO BARCELONA NO.23
PERUMAHAN PALEM SEMI KARAWACI
TANGGERANG
CINDI PRASASTI - 02129662588| N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
158 3983 KLINIK & APOTEK KF CITRA
RUKO TAMAN PALMA JL. RAYA
BOULEVARD BLOK G1 NO.25R CITRA
RAYA-CIKUPA
TIKASARI 02159409460| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
159 0772 MEDIPRO CLINIC PASAR KEMISPERUM WISMA MAS, BLOK A1, NO.30-
31, PASAR KEMIS, KUTA JAYAIBU DIANA KOORDINATOR 021-59318964| 021-59318965 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
koord.pasarkemis@medicompri
ma.co.id
160 0021SILOAM HOSPITALS LIPPO VILLAGE
(KARAWACI)
JL. SILOAM NO.6, LIPPO KARAWACI
1600
ROOSMEINY
KARTIKA
PUTRI/DIH/LINA
MARKETING 021-546 0055/25668000|021-
5460921/546008Y Y Y ACTIVE ALL COVERAGE
Roosmeiny.Kartika@siloamhospit
als.com
161 3532 CLINIC ICON 8JL. HORISON BROADWAY BLOK M2 NO.
3 BSD CITY , TANGERANG
DR. JOHANES/
DR.MELANIOWNER
(021) 33438000/ 021
94588000|(021) 68538820 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
162 3978 KLINIK & APOTEK KF 447 CIRENDEU JL. CIRENDEU RAYA NO.27C CIPUTATANANDA DESSI
S.FARM.APT- 021-7415997| -021-7415997 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected]/bmjay
163 3979 KLINIK & APOTEK KF 267 BINTAROJL. BINTARO UTAMA V BLOK EA 2
NO.35 BINTARODEWI EKASARI - 021-7371018| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
164 1774 RS. DR. SUYOTO PUSREHAB KEMHAN JL. RC VETERAN NO. 178 BINTARO WULANSARI Marketing 021-73884000|021-7342581,
7369156Y Y Y ACTIVE ALL COVERAGE [email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 6 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI165 3999 KLINIK PESONA LEGOK
JL. RAYA LEGOK KM 7 DESA CIJANTRA
KEC. LEGOK, KARAWACI, TANGERANG,
BANTEN
DR. EDDY OWNER 021-54220281| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
166 1682 RSU. ST CAROLUS SUMMARECONJL. GADING GOLF BOULEVARD KAV. 08
GADING SERPONG
IBU KURNIA
AGUSTIN/IBU
MARLIANI
MARKETING 021-54220811| 021-54220810 Y Y Y ACTIVE ALL [email protected];
nia@carolussummarecon.
167 1637 RS. MULIA INSANIJL. RAYA SERANG KM 16.8 CIKUPA
TANGERANGIBU EKA / IBU NEVA MARKETING
021-
5962790/5962998/5962996
|
021-5963099 Y Y Y ACTIVE ALL [email protected]/neva
168 1487 RS. MULYAJL. KH.HASYIM ASHARI NO.18
SUDIMARA PINANGIBU NINA MARKETING 021-7322443|
021-
7310721/7322445Y Y Y ACTIVE ALL COVERAGE
[email protected]/nina.mkt.
169 1768 KLINIK SATELIT GSM TANGERANG
JL. KH. HASYIM ASHARI BABAKAN
TANGERANG, RUKO MODERNLAND
BLOK AR NO 19-20
IBU RATNA - 021-55748000| 021-4254816 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
-
170 1659 RS. HERMINA CIPUTATJL. CIPUTAT RAYA, NO.2 KERTAMUKTI
CIPUTAT
IBU HERA/ IBU
DETAMARKETING 021-74702525| 021-74700999 Y Y Y ACTIVE ALL COVERAGE
om
171 1669 RSIA. BUAH HATI CIPUTATJL. ARIA PUTRA NO 399 SERUA INDAH
CIPUTAT - TANGERANGBP WIDI MARKETING 021-74632222| 021-74638568 Y Y Y ACTIVE ALL COVERAGE [email protected]
172 1670 CIPUTRA HOSPITALJL. CITRA RAYA BOULEVARD BLOK V
00/08 SEKTOR 3,4 KEC PANONGAN
IBU RISA
HARTIYASARI / DR
MONICA
MARKETING 021-59405555| 021-59405678 Y Y Y ACTIVE ALL COVERAGErisa.hartiyasari@ciputrahospital.
com
173 1812SMILE N SHINE DENTAL CARE
CENTER
ALAM SUTERA TOWN CENTER (ASTC)
BLOK 10D NO 6 TANGERANGDR. SUSANTY Owner 021-96679191| 021-29008540 N Y Y PARTIAL DENTAL [email protected]
174 1866 KLINIK SATELIT GSM BINTARORUKO ELANG RAYA KAV. 1 NO 10-11 JL.
BINTARO JAYA SEKTOR IX- - 021-7450818| 021-7450642 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
175 1867 KLINIK SATELIT GSO CENGKARENGBANDARA INTERNASIONAL SOEKARNO
HATTA CENGKARENG, TANGERANGDRG IVIE - 021-5501801| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
176 1947 KLINIK & APOTEK KF 219JL. IR H JUANDA NO 111
SITUGINTUNG, CIPUTAT- - 021-7401868| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
d
177 1810RS. KHUSUS BEDAH THT
PROKLAMASI BSD
COMMERCIAL PARK CENTRAL
BUSINESS OF DISTRICT BSD KAV.7
TANGERANG SELATAN
BP FREDI - 021-29002929| 021-29002930 Y Y Y ACTIVE ALL COVERAGE [email protected]
178 1935 APOTIK FARMARIN IV BINTAROBINTARO UTAMA SEKTOR 3 BLOK AM,
BINTARO JAYA
IBU WAHTYU FITRIA
WATI- 021-7357077| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
179 1948 KLINIK & APOTEK KF 115JL. PAMULANG PERMAI RAYA NO D2/1A
TANGERANG- - 021-7498708| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
180 2081 RSIA. RP SOEROSOJL. ARIA PUTRA NO. 9 KEDAUNG
PAMULANG, TANGERANG SELATANYOSIE NOVERHA MARKETING 021-7499199/ 7401376| 021-7400956 Y Y Y ACTIVE ALL COVERAGE [email protected]
181 1985 RS. MEDIKA LESTARI
JL. HOS COKROAMINOTO PERUM
PONDOK LESTARI BLOK C.1 NO.1-2
CILEDUG
IBU SULAS Marketing 021-5854858|021-7304150/021-
7320Y Y Y ACTIVE ALL COVERAGE [email protected]
182 1555 RSIA. DHIAJL. CENDRAWASIH NO.90, SAWAH
LAMA CIPUTAT, TANGERANG SELATANBPK SYARIEF MARKETING 021-7494550/ 70310242| 021-7494551 Y Y Y ACTIVE ALL COVERAGE
183 2128 KLINIK VIVA MEDIKA TANGERANGRUKAN TEUNGKU UMAR BLOK A1/A2
KARAWACI TANGERANG- - 021-55772097/99| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
184 2130KLINIK VIVA MEDIKA DIABETES
CARE
JL. JALUR SUTRA TIMURKAV. A20 NO
19-20 KUNCIRAN PINANG TANGERANGDR.RONI/ PUJI koordinator 021-71343034| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
185 1949 KLINIK & APOTEK KF 78 JL. A YANI NO 135 TANGERANG ARIA Y ARMOKO - 021-5518433| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR8124484451
186 1968 BETHSAIDA HOSPITAL
DISTRICT TIVOLLI NO. 1 PARAMOUNT
SERPONG, JL. BOULEVARD GADING
SERPONG, TANGERANG
DRG. FENDERIA L.S.
MHA- 021-29309999| 021-29305999 Y Y Y ACTIVE ALL COVERAGE
general.practise@bethsaidahospi
tals.com
187 2360 RS. PERMATA IBU TANGERANGJL. KH. MAS MANSYUR NO.2 KUNCIRAN
TANGERANG
IBU OVA
(081316052411)Marketing 021-7334343/ 7300883| - Y Y Y ACTIVE ALL COVERAGE [email protected]
BENGKULU
188 2108 APOTEK KIMIA FARMA 72 BENGKULU JL. SUPRAPTO NO. 48 BENGKULU BPK TONI - 0736-20601| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
189 0848 RS. TIARA SELLAJL. S PARMAN NO. 61 PADANG JATI,
BENGKULUIBU ENSI Marketing
0736-20350021-
8221574|021-82215740736-20626 Y Y Y ACTIVE ALL COVERAGE [email protected]
190 1551 RS. BHAYANGKARA BENGKULU JL. VETERAN, NO.2 BPK. SANDY MARKETING 0736-341086/21553| 0736-349050 Y Y Y ACTIVE ALL COVERAGErsbhayangkarabengkulu@yahoo.
com
191 1021 RS. RAFFLESIA BENGKULU JL. MAHONI, NO.10, PADANG JATIBPK.AMIRUDIN /
BPK.ALITATAUSAHA 0736-21710-|-
0736-
342677/21954Y Y Y ACTIVE ALL COVERAGE
BENGKULU
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 7 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI192 2109
APOTEK KIMIA FARMA 220
BENGKULUJL. S. PARMAN BENGKULU IBU INTAN - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
BANTUL
193 1437 RS. PKU MUHAMMADIYAH BANTUL JL. JEND. SUDIRMAN 124-126 IBU MARISKA WADIR KEUANGAN 0274-368587| 0274-368586 Y Y Y ACTIVE ALL COVERAGE [email protected]
SLEMAN
194 1229JOGJA INTERNATIONAL HOSPITAL
(JIH)
JL. RING ROAD UTARA NO.160
CONDONG CATUR SLEMANBPK AGUNG MARKETING 0274-4463535/4463190| - LIHAT REMAKS Y Y Y ACTIVE ALL COVERAGE
[email protected]; desy@rs-
jih.co.id
195 2974 RSI. YOGYAKARTA PDHIJL. SOLO KM. 12,5 KALASAN, SLEMAN,
YOGYAKARTA
ZULFA ADZKIA/
WAHYUMARKETING (0274) 498000| (0274) 498464 Y Y Y ACTIVE ALL COVERAGE [email protected]
196 1674 RS. PKU MUHAMMADIYAH UNIT IIJL. WATES KM 5,5 GAMPING SLEMAN
YOGYAKARTA
BPK GATOT HERU
SUGIARTOADM 0274-6499704/6499706| 0274-6499727 Y Y Y ACTIVE ALL COVERAGE
YOGYAKARTA
197 2864 RS. AN NUR JL. N.COLOMBO, NO. 14, YOGYAKARTA BPK ARI Humas 0274-585848/0274-514784| 0271-564110 Y Y Y ACTIVE ALL COVERAGE [email protected]
198 2768 KIMIA FARMA 21 JL. MALIOBORO - YOGYA NOVIARDI KOORDINATOR 0274 514980| N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
199 2170 APOTEK FARMARIN YOGYAKARTAJL. P. MANGKUBUMI NO.73
YOGYAKARTA
WUNAWAR, S.
FARM, APTAPOTEKER 0274-7822198| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
d
200 0077 RS. BETHESDA YOGYAKARTA JL. JEND.SUDIRMAN NO.70
IBU NUR
SUKAWATI/IBU RINI
HAPSARI
HUMAS0274-586688/5622460274 -
586688|0274 -586688
0274-
563312,521251Y Y Y ACTIVE ALL COVERAGE [email protected]
201 2615 KLINIK & APOTEK KF 225 JL. GODEAN KM 5 NO. 23 MODINANTENTI
HERAWATI.,S.F.,APT0274 621791| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
202 2616 KIMIA FARMA 401 JL. SETURAN,C 3/B, JOGJADIAN SHINTARI
RAHAYU, S.SI, APT- 0274 4332880| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
203 2617 KLINIK & APOTEK KF 275 JL. KALIURANG, JOGJADRA ERNA RAHAYU
NINGHSIH APTpenanggung jawab 0274 885220| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
204 2618 KLINIK & APOTEK KF 70 JL. ADISUCIPTO 63A, JOGJAKARTA
DRA. ERNA
RAHAYUNNINGSIH,
MBA, APT
- 0274 489135| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
205 2619 KLINIK & APOTEK KF 316 JL. PALAGAN, JOGJAPRIHASTUTI,S.FARM
.,APT- 0274 869944| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
206 1400 RSU. BETHESDA LEMPUYANGWANGI JL. HAYAM WURUK NO.6 IBU ROSITA MARKETING 0274-512257/588002| 0274-547253 Y Y Y ACTIVE ALL [email protected]
m
207 1286 RS. HAPPYLAND MEDICAL CENTERJL. IPDA TUT HARS. ONO NO. 53,
TIMOHO
BPK.
HARMINTO/AJENGMARKETING 0274-550060/58| 0274-550061 Y Y Y ACTIVE ALL COVERAGE [email protected]
208 0604 RS. LUDIRA HUSADA TAMA JL. WIRATAMA NO.4 TEGALREJO 55244 IBU LUCIA EMIYATI MARKETING0274 6203330274-
620091|0274-6200910274-589087 Y Y Y ACTIVE ALL COVERAGE [email protected]
209 3297 LAB. CITO YOGYAKARTAJL. ATMOSUKARTO NO. 4 KOTABARU
YOGYAKARTARukisti wuri - 0274 563656| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
210 0747 RS. PANTI RAPIH JL. CIK DITIRO, NO.30 IBU ELIZA KONDA PPU0274-
514014/514845/563333|0274-564583 Y Y Y ACTIVE ALL COVERAGE [email protected]
211 0606RS. PKU MUHAMMADIYAH
YOGYAKARTAJL. K.H. ACHMAD DAHLAN, NO.20 BPK. EKA/ IBU LELI MARKETING 0274-512653-|- 0274-566129 Y Y Y ACTIVE ALL COVERAGE
JAKARTA BARAT
212 0782 KLINIK MHT ANGKEJL. TUBAGUS ANGKE NO.27. TAMAN
DUTA MAS BLOK D-9B NO.2-3DR TIWI/IBU ATI
KOORDINATOR
MARKETIN021- 5675259/5679165| 021-5679165 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
213 2640 KLINIK & APOTEK KF 254JL. RAYA POS PENGUMBEN NO.11
JAKARTA BARAT
DRS. I. NYOMAN
SUKRA DARS. ANA,
APT.
- 021 5349063| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
214 1479 RS. PONDOK INDAH PURI INDAHJL. PURI INDAH RAYA BLOK S2,
KEMBANGAN SELATANIBU YUNITA SARI MARKETING 021-25695222/25695200| 021-25695265 Y Y Y ACTIVE ALL COVERAGE [email protected]
215 0018 RS. PELNIJL. AIP II K.S. TUBUN, NO.92-94,
PETAMBURAN
DR. SRI RACHMANI
M.KES, MHKESMARKETING
021-5306901-
9/5349475/5460608/54848
09021-5484809|021-
5484809
0215483145/5306
904/7Y Y Y ACTIVE ALL COVERAGE [email protected]
216 0736 RSUD. CENGKARENGJL. N. KAMAL RAYA, BUMI CENGKARENG
INDAH, CENGKARENG TIMURBPK SIGIT EXT 730 MARKETING
021-54372874/5/6 /
54372882|021-54374579 Y Y Y ACTIVE ALL COVERAGE
m
217 0390 RS. HERMINA DAAN MOGOTJL. KINTAMANI RAYA, NO.2, KAW.
DAAN MOGOT BARU
IBU ANIS/BPK
HENDRAMARKETING 021-5408989| 021-5449869 Y Y Y ACTIVE ALL COVERAGE
daanmogot@herminahospitalgro
up.com
218 0952 RS. PATRIA IKKTJL. CENDRAWASIH NO.1 KOMP
DEPHAN/MABES TNIDR. BUN / IBU SARI MARKETING 021-5308981-84-|- 021-5346387 Y Y Y ACTIVE ALL COVERAGE [email protected]
DAERAH ISTIMEWA YOGJAKARTA
DKI JAKARTA
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 8 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI219 1701
KLINIK DR. SANDER B (N/B KLINIK
DAYA MEDIKA)
JL. TOMANG TOL RAYA A1 NO 17-18
KEDOYA SELATAN, KEBON JERUKMULJANTO/ERWIN MARKETING 021 - 5812781/82| 021-5806065 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
220 1945 KLINIK & APOTEK KF 96JL. LET JEND S PARMAN KAV G/12,
SLIPI, JAKARTA BARATKhaerul - 021-5481140, 5321551| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
221 0846 RS. JANTUNG HARAPAN KITA JL. LETJEN S PARMAN KAV.87 SLIPIIBU NETTY N. E.
SIREGAR
PELAYANAN
PELANGGAN021-5684093 / 5684085| 021-5601816 Y Y Y ACTIVE ALL COVERAGE [email protected]
222 0695 KLINIK KUSUMA I JL. PETA SELATAN, NO.50 DR MEIDI penanggung jawab 021-541 9747| 021-54360626 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
223 1158 RS. SUMBER WARAS JL. KYAI TAPA - GROGOL BPK. BAMBANG MARKETING 021-5682011/5605800| 021-5605791 Y Y Y ACTIVE ALL [email protected]/
sekretariat@rssumberwa
224 1102 RS. BHAKTI MULIA JL. AIPDA K.S.TUBUN, NO.79 DR DEVI Marketing 021-5481625-|- 021-5331544 Y Y Y ACTIVE ALL COVERAGE [email protected]
225 1127 JESSLYN MEDICAL CENTERPERUM.TAMAN SURYA III BLOK F/63
CENGKARENGDR. AGUS KOORDINATOR 021-54365638| 021-54365638 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
226 0643 RSB. GRHA KEDOYA JL. PANJANG NO 26, KEDOYA UTARA IBU TITIK RENGGO - 021-56982222/29910999|02129910987/569
82233Y Y Y ACTIVE ALL COVERAGE
[email protected]/info@g
rhakedoya.com
227 0381 RS. MHT CENGKARENG JL. DAAN MOGOT, KM.17 DR.TIWI MARKETING 021-54396298/6194581| 021-6194581 Y Y Y ACTIVE ALL COVERAGE [email protected]
228 0204 RS. MEDIKA PERMATA HIJAU JL. RAYA KEBAYORAN LAMA, NO.64 IBU SRI SUWARNIKEUANGAN/MARKE
TING
021 - 530 5288, 534
7411021 - 534 741|021 -
534 741
021-
53652856/530529
1
Y Y Y ACTIVE ALL [email protected];
229 0109 RSAB. HARAPAN KITA JL. JEND S.PARMAN, KAV.87, SLIPIFAKHRUDDIN/SRIEN
DAHPemasaran
021-
5668284/5686404/5683053
021-566 8284|021-566
8284
021-
5601816,5668285Y Y Y ACTIVE ALL COVERAGE
sriendahsetyaningrum_rsabhk@
yahoo.com
230 0836 RS. ROYAL TARUMA JL. DAAN MOGOT NO.34 GROGOL IBU ORI/ LELI PEMASARAN 021-56958338/56967788-|- 021-56958589 Y Y Y ACTIVE ALL COVERAGEkasirrawatinap@rs-
royaltaruma.com
231 0783 KLINIK MHT KALIDERESJL. PETA SELATAN RAYA-KALIDERES
INDAH I BLOK A NO.12DRG RATNA KOORDINATOR 021- 5456027| 021- 5456027 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
232 0101 SILOAM HOSPITALS KEBON JERUKJL. RAYA PERJUANGAN, KAV.8, KEBON
JERUK
IBU LIANA WIDJAJA/
BPK. PUTRAMARKETING
021- 25677888021-
5300889|021-5300889021-5321766 Y Y Y ACTIVE ALL COVERAGE
liana.natawidjaja@siloamhospital
s.com
233 3211 GETHEALTHY CLINIC
RUKAN SIXTH AVENUE J01 A NO. 20-
22, CITRA 6, KALIDERES, JAKARTA
BARAT
DR. ANGGRAINI
PUSPITAMarketing 021-29030041/42| 021-29030045 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
234 2127KLINIK VIVA MEDIKA TANJUNG
DUREN
JL. TANJUNG DUREN RAYA BLOK A
NO.38 JAKARTA BARATANI - 021-5640602/ 5641479| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
235 2294 RS. JAKARTA EYE CENTER KEDOYAJL. TERUSAN ARJUNA UTARA NO. 1
KEDOYA, JAKARTA BARAT 11520ANDHY SUYATNO - 021-29221000| - Y Y Y ACTIVE ALL COVERAGE -
236 0771 KLINIK YADIKA TEGAL ALURJL. KAMAL RAYA BLOK A7 NO.7-11
TEGAL ALUR
DR SAPTAJI / IBU
ETI
PENANGGUNG
JAWAB/ HR021-70605247 / 55351876| 021-55963484 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
d
JAKARTA PUSAT
237 0790 RSIA. BUNDA JAKARTAJL. TEUKU CIK DITIRO NO.28,
MENTENGBPK.SAMUEL MARKETING
(021) 3143215(021)
31922005|(021) 31922005
021-
3101313,3928588Y Y Y ACTIVE ALL COVERAGE [email protected]
238 0398 RS. MH. THAMRIN INTERNASIONAL JL. SALEMBA TENGAH, NO.26-28Bpk.DJATMIKO /
IBU.RITAMARKETING 021-3904422|
021-
3926934,3926931Y Y Y ACTIVE ALL COVERAGE
marketingthamrinsalemba@gmai
l.com
239 0705 KLINIK SWA INDOMEDIKAJL. JEND SUDIRMAN KAV 1, GD BNI
LANTAI BASEMENT 1IBU TANTI MARKETING 021-5728987| 021-5728990 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
240 0397 KLINIK BARUNA JL. CIKINI RAYA, NO.60 R/S DR.ASTRID MARKETING 021-3141040-059| 021-3151065 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
241 0011 RS. MITRA KEMAYORAN JL. LANDAS PACU TIMUR, KEMAYORAN IBU ESTIMARKETING
MANAGER021-6545555/888| 021-6545959 Y Y Y ACTIVE ALL COVERAGE
marketing2.kmy@mitrakeluarga.
com
242 1477 BUNDA INTERNASIONAL CLINICJL. TEUKU CIK DITIRO NO.12,
MENTENG
BPK HILMA/IBU
FIKA
KEUANGAN/MARKE
TING021-3926393| 021-3926494 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
243 0013 RS. PGI. CIKINI JL. RADEN SALEH, NO.40IBU RATNA/IBU
IRENEMARKETING 021-38997777|
021-324663/
3910277Y Y Y ACTIVE ALL COVERAGE [email protected]
244 1590 RS. BEDAH THT PROF. NIZAR JL. KESEHATAN NO.9 IBU HERA/IBU VITA MARKETING 021- 3503435/34834982| 021-34834982 Y Y Y ACTIVE ALL COVERAGE [email protected]
245 1577 KLINIK MIRACLE ( GD INDOFOOD )INDOFOOD TOWER - PLAZA SUDIRMAN
LT 8, JL. JEND SUDIRMAN KAV 76-78DR RITA/BPK ERIK MARKETING 021-57954537/38| 021-57954541 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
246 0953RS. ISLAM JAKARTA (CEMPAKA
PUTIH)JL. CEMPAKA PUTIH TENGAH I/1
BPK BAMBANG/IBU
WIWIK/BPK SOBARI
MARKETING/AdmR
.Inap
021-4250451/42801567021-
42801567|021-42801567021-4206681 Y Y Y ACTIVE ALL COVERAGE
[email protected]/rsijpu
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 9 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI247 1105 RS. JAKARTA EYE CENTER MENTENG
JL. CIK DITIRO 46,MENTENG JAKARTA
10310DIAH / MAS ANDI
MARKETING
CONSULT
021-29221000021-
31935600|021-31935600021-3904601 Y Y Y ACTIVE ALL COVERAGE jec@jakarta_eye_center.com
248 1709KLINIK YAKES MANDIRI-WISMA
MANDIRI
WISMA MANDIRI LT I, JL. MH THAMRIN
NO 5BP SLAMET WIYOTO - 021-39832805| 021-39832806 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
249 1700 FHL DENTAL CLINICGEDUNG BRI II LT.15 SUITE 1509 JL.
JEND SUDIRMAN NO 44-46
DRG KRISTIN
RATNAWATI- 021-57851127/ 57930552| - N Y Y PARTIAL DENTAL [email protected]
250 1702 RS. KHUSUS BEDAH SS MEDIKA JL. SALEMBA I NO 11 JAKARTA PUSATBPK IRVAN HELMI/
IBU DWI HESTIMARKETING 021-3913336/3926689| 021-3926687 Y Y Y ACTIVE ALL COVERAGE [email protected]
251 1820 RSU. BUNDA JAKARTAJL. TEUKU CIK DITIRO NO.21,
MENTENG- - 021-31922005| - Y Y Y ACTIVE ALL COVERAGE [email protected]
252 1914 RSUD. TARAKANJL. KIYAI CARINGIN NO 7, JAKARTA
PUSAT
BPK SUGIYANTO /
IBU LINA MARLINAMarketing 021- 3503003, 3842934,|
021-3810149,
3503412Y Y Y ACTIVE ALL COVERAGE [email protected]
253 1019RSPAD GATOT SUBROTO
(P.DARMAWAN)JL. ABDUL RACHMAN SALEH NO.24
IBU NOVA, NITA,
FEBRIANAAdmin
021-3500004021-
376134|021-376134
021-
3441903/3859460Y Y Y ACTIVE ALL COVERAGE [email protected]
254 0599 RS. KRAMAT 128 JL. KRAMAT RAYA, NO.128BPK HERI/IBU
WIWIKMARKETING
021-
3909814/3918287/3909514
|
021-3909125 Y Y Y ACTIVE ALL [email protected];
255 1115 RSPAD GATOT SUBROTO (PAV.IKA) JL. ABDUL RACHMAN SALEH NO.24BPK AHMAD & IBU
SANTIMARKETING 021-3504614| 021-3520643 Y N Y ACTIVE ALL COVERAGE [email protected]
256 1406 APOTIK FARMARIN I KEBON SIRIH
GEDUNG BANK INDONESIA JL. KEBON
SIRIH NO 82 DAN 84 GEDUNG KEBON
SIRIH LT 1
SHANTI INDAH
PALUPIKOORDINATOR 021-29810000 / 29815268| 021-2311940 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
apotikfarmarin_kebonsirih@yaho
o.com
257 1197 RSPAD GATOT SUBROTO (NON. PAV) JL. ABDUL RACHMAN SALEH NO.24IBU JUJU / HERMIN/
BPK AHMADMarketing 021-3448929| 021-3448929 Y N Y ACTIVE ALL COVERAGE [email protected]
258 1069RSPAD GATOT SUBROTO(P.IMAM
SUJUDI)JL. ABDUL RAHMAN SALEH NO.24 BPK AHMAD MARKETING 021-3441008-|- 021-3859460 Y N Y ACTIVE ALL COVERAGE [email protected]
259 1078 RSIA. BUDI KEMULIAAN JL. BUDI KEMULIAAN NO.25 IBU KIKI MARKETING 021-3842828-|- 021-3501012 Y Y Y ACTIVE ALL COVERAGE [email protected]
260 1358 RSIA. YPK - MANDIRI JL. GEREJA THERESIA, NO. 22 IBU NINDI MARKETING 021-3909725| 021-3909806 Y Y Y ACTIVE ALL COVERAGE [email protected]
261 0084 RS. JAKARTA JL. JEND. SUDIRMAN, KAV.49 BPK FAUZI MARKETING021-5732241/5741828021-
5741828|021-5741828021-5719870 Y Y Y ACTIVE ALL COVERAGE [email protected]
262 0180 RSU. MENTENG MITRA AFIA JL. KALI PASIR, NO.9 DR. NADIA MARKETING 021-3154050/3909484| 021-3146309 Y Y Y ACTIVE ALL [email protected];
263 0042 RS. PERTAMINA JAYA JL. A. YANI NO.2 IBU. YAYAT/MONA KOORDINATOR021-4204056/4211911021-
4211911|021-4211911021-4211913 Y Y Y ACTIVE ALL COVERAGE [email protected]
264 0135 RS. ABDI WALUYO JL. H.O.S. COKROAMINOTO, NO.31-33 DR. MIGOT/IBU ENYMARKETING /
KEUANGAN021-3144989| 021-31930866 Y Y Y ACTIVE ALL COVERAGE
265 0793 KLINIK YES CARE JL. WAHID HASYIM NO. 31C DRG ELDA Direktur 021-3915487| 021-3146659 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
266 0789 KLINIK MHT SERDANG JL. H. UNG E - 71/2 KEMAYORAN
DRG ATI
SARASWATI/BPK
APRI
KOORDINATOR/AD
M RJ021-4249519| 021- 4249519 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
267 0029 RSU. EVASARI JL. RAWAMANGUN NO.47 - PRAMUKA DR. DINA HANUMMarketing /
Keuangan021-4202851/52| 021-4209725 Y Y Y ACTIVE ALL COVERAGE
268 0787RS. KHUSUS THT-BEDAH
PROKLAMASIJL. PROKLAMASI NO.43 BPK MANSYUR MARKETING
021-
3900002/3906893/3144795
/3909783|
021-
3900947/3152548Y Y Y ACTIVE ALL COVERAGE [email protected]
269 0802SAHID SAHIRMAN MEMORIAL
HOSPITALJL. JEND.SUDIRMAN, NO.86 IBU TATI MARKETING
021- 57853911021-
5727210|021- 5727210021- 57853922 Y Y Y ACTIVE ALL COVERAGE
[email protected]/tatilamb
270 1495 APOTEK & KLINIK KF INDOSATGD. INDOSAT LT.23 JL. MEDAN
MERDEKA BARAT NO. 1 JAKARTA PUSAT
DRS. MARULY
MARPAUNG, APTKOORDINATOR 021-30003750| 021-30003750 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
271 0788RSPAD GATOT SUBROTO
(PAV.KARTIKA)JL. ABDUL RACHMAN SALEH NO.24 BPK AHMAD MARKETING
021-384 0484, 3441008021-
376134|021-376134
021-
3859460,3501308Y Y Y ACTIVE ALL COVERAGE [email protected]
272 1026 RSIA. TAMBAK JL. TAMBAK,NO.18 MANGGARAI IBU. AYA/ FITRI MARKETING021-
2303444/087880676072|-021-3902550 Y Y Y ACTIVE ALL COVERAGE
273 2637 KLINIK & APOTEK KF 2 JL. RAYA SENEN NO. 66DRA. ASTRID
DWIASTUTI, APT.- 021 384-4788; 384-0742| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
274 2507MITRASANA IHC KALBE CEMPAKA
PUTIH
JL. LETJEN SUPRAPTO KAV 4 CEMPAKA
PUTIH, JAKARTA PUSATINDAH - 021-42873888 EXT : 1451| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
275 3737 CHILDLABJL. KRAMAT RAYA NO. 53, JAKARTA
10450, INDONESIAIMELDA NOVIANTI - (021) 31907979| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHARImelda Novianti
276 4058 KLINIK YPK MANDIRIGEDUNG GRAHA MANDIRI LT.1 LOBBY
SELATAN,JL. IMAM BONJOL NO.61IBU WENNY KOORDINATOR 021 - 39838556| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 10 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI277 2733 KINAN MEDICAL CENTER
KOMPLEK RUKO RAWASARI MAS
NO.B10 JL. PERCETAKAN NEGARA,
CEMPAKA PUTIH JAKARTA PUSAT
KISWORO - -| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
m
278 2735 THOMSON SPECIALIST CENTERJL. IMAM BONJOL NO.72, MENTENG
JAKARTA PUSAT 10310
IBU GRATA
A.PUSPANINGRUM- 021-3910030| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
279 1633KLINIK GARUDA SENTRA MEDIKA (
GSM )
JL. ANGKASA BLOK B.15 KAVLING 1,
KEMAYORAN
BPK YOGO/ IBU
RETNOMARKETING 021-4241000| 021-4254816 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
280 2745 KYOAI MEDICAL SERVICESWISMA KEIAI LT. 6 JL. JEND
SUDIRMAN KAV 3-4 JAKARTABPK ERY marketing 021-5734550| 021-5736790 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
281 2405 HENDRA HIDAYAT IMPLANT CENTER
SAHID SUDIRMAN RESIDENCE LT. 1
UNIT 1, JL. JEND. SUDIRMAN NO. 86
JAKARTA PUSAT
IBU RINI MARKETING 021-52970102/104| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
282 1054 RS. HUSADAJL. RAYA MANGGA BESAR 137-139,
JAKARTA PUSAT BAG UTARA
IBU MEYLISA / IBU
RINA/CATURMARKETING
021-6260108021-
6490090|021-6490090021-6497494 Y Y Y ACTIVE ALL COVERAGE
283 0600 RS. ST. CAROLUS JL. SALEMBA RAYA, NO.41DR. WELLEM H.
T/DR. UTIE/FARIDA
Marketing/CO
Klinik021-3904441|
021-
3922831/3154183Y Y Y ACTIVE ALL COVERAGE
284 2406HENDRA HIDAYAT DENTAL CENTER
(HHDC)
THAMRIN CITY - OFFICE SUITE FLOOR
3 UNIT 2, JL. KH. MAS MASYUR
JAKARTA
DEBRA -
08164830122- 021-3199 7482| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
285 2636 KLINIK & APOTEK KF 1 JL. GARUDA NO.47, JAKPUS MARULI MARPAUNG - 021 424-5572| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected]/kimi
JAKARTA SELATAN
286 3974 LAB. KLINIK CITO JAKARTA
JL. RS. FATMAWATI NO. 27 A, RT.001
RW.006 KEL. GANDARIA SELATAN,
CILANDAK, JAKSEL
IBU NINA (021) 766 4036| (021) 766 3640 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
om
287 4234RAYS INTERNATIONAL DENTAL
CLINIC
JL. BRAWIJAYA VIII NO. 2, JAKARTA
SELATANIBU ENDANG KOORDINATOR 021-7262347| 021-7225844 N Y Y ACTIVE ALL COVERAGE [email protected]
288 3989KLINIK & APOTEK KF NO. 55
KEBAYORAN
JL. KEBAYORAN LAMA NO. 34K
JAKARTA SELATANWAHYU DWI - 021-7226444/7203563| 021-7203563 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
289 0597 KLINIK JMC DHARMA BHAKTI JL. CILANDAK KKO RAYA NO.45 IBU SRI WAHYUTI MARKERTING021-781 9848 /
0217989123|- N Y Y ACTIVE ALL COVERAGE [email protected]
290 2932 APOTEK KF55 CINERE
PLN P3B JB KRUKUT-LIMO, CINERE
16514, KOTAK POS 159 CINERE
JAKARTA SELATAN
WAHYU DWI
PURNOMO- 021 7220292| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
291 3540FHL DENTAL CLINIC EPPIWALK
OFFICE
EPPIWALK OFFICE SUITES LT. 6 UNIT B
629, JL. H.R. RASUNA SAID KEL. KARET
KUNINGAN KEC. SETIABUDI
DR. CHRISTIN - 021-29912232| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
292 0854 RS. ZAHIRAH JL. SIRSAK NO.21, JAGAKARSA IBU ARINI INDAH MARKETING
021-
78888723/7872210/788887
21021-78888723|021-
78888723
021-
7270013/7872210Y Y Y ACTIVE ALL COVERAGE [email protected]
293 0797 RS. MEDISTRA JL. GATOT SUBROTO KAV.49 IBU YORA/ ELLI MARKETING 021-5210200| 021-5210184/5 Y Y Y ACTIVE ALL [email protected];
294 2954 KLINIK AJI WARAS KARANG TENGAH
JL. KARANG TENGAH RAYA NO.60,
LEBAK BULUS, CILANDAK, JAKARTA
SELATAN 12440
DRG. ESTHER - (021) 75909473| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
295 1712KLINIK SUNFLOWER DENTAL &
HEALTH CARE
JL. KARANG TENGAH RAYA NO.8V
BONA INDAH BISNIS SENTER, LEBAK
BULUS
BP SUJIO - 0212923-7071, 7110-6511| 021-29203541 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
296 2807KLINIK PERTAMEDIKA PONDOK
RANJI
JL. WR SUPRATMAN NO. 43 (KAMP
UTAN) TANGERANG SELATANANNA - 021-7355253| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
297 1488 RS. ASRI JL. DUREN TIGA RAYA, NO.20 BPK BUDI / IBU ANI MARKETING 021-7995566,7992211|02179198118/791
98733Y Y Y ACTIVE ALL COVERAGE [email protected]
298 2797 KLINIK PERTAMEDIKA PHEPHE TOWER LT. 2 JL. TB SIMATUPANG
KAV. 99TRES - 021-29547300| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
299 1066MRCCC-SILOAM HOSPITALS
SEMANGGI (D/H SPECIALIST C
JL. GARNISUN 2-3 KARET, SEMANGGI
SETIABUDI (BELAKANG UNIV.
ATMAJAYA ) JAK- SEL
YUNITA
SULISTYOWATI/IBU
DEBORAH/AGUSTIN
E
Business &
Marketing021-29962888| 021-29962778 Y Y Y ACTIVE ALL COVERAGE
marketing.mrccc@siloamhospital
s.com;mrccc.corpor
300 1752 LAB. KLINIK BIOTEST WIJAYAJL. WIJAYA I NO 58, KEBAYORAN
BARU, JAK-SELIBU NINA/YANTI Marketing 021-7232445| 021-7268711 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected];biol
301 1936 APOTIK FARMARIN VI RASAMALAWISMA PPBI JL. RASAMALA NO.2
PANCORANYANUILA DARYATI - 021-8290073| 021-83794460 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 11 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI302 2086 KLINIK GLOBAL DOCTOR
JL. KEMANG RAYA NO. 87 JAKARTA
SELATANBP SUGANDI IT/GA 021-7194565| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
303 2082 BRAWIJAYA CLINIC @ FX SUDIRMAN
FX SUDIRMAN LT 5 (F5) KAV. 8A-8B, JL.
JEND SUDIRMAN PINTU SATU SENAYAN
JAKARTA
SYUKRIAH - 021-25554156| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
304 2033 KLINIK NAMIRAJL. JATIPADANG RAYA NO. 62 PASAR
MINGGUBPK AIRLANGGA - 021-7820645/78830676| 021-7820645 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
305 0228 RSIA. KEMANG MEDICAL CARE JL. AMPERA RAYA, NO.34,KEMANG
IBU LENI
SUSILAWATI/TRI
WULANDARI
MARKETING
021-
27545454/27545400/021-
6317288|021-6317288
021-78843548 Y Y Y ACTIVE ALL COVERAGEmarketing@kemangmedicalcare.
com
306 2174 SILOAM HOSPITALS SIMATUPANGJL. RA KARTINI NO.8 CILANDAK
JAKARTA SELATAN, 12430ARIE ARIMBI Marketing 021 2953 1900 EXT 22601| 021 759 16997 Y Y Y ACTIVE ALL COVERAGE
anastasia.hermawan@siloamhos
pitals.com
307 2138 KLINIK PERTAMEDIKA PATRA JASAPATRA JASA OFFICE TOWER, JL. JEND.
GATOT SUBROTO KAV.32-34LILI - 021-5228026/ 5217318| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
308 2139 KLINIK PERTAMEDIKA SINABUNG
JL. SINABUNG II NO. 32 AF KEL.
GUNUNG KEC. KEB. BARU JAKARTA
SELATAN
SUNARDI - 021-7243262/7243282| 021-72800985 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
309 0796RS. METROPOLITAN MEDICAL
CENTRE ( MMC )
JL. HR. RASUNA SAID, KAV. C21,
KUNINGAN
DR.LITA CORNELIA/
IBU RATIHMarketing 021- 5203435/0811865958|
021-
5226070/5227060Y Y Y ACTIVE ALL COVERAGE
[email protected]/marketi
310 2229BRAWIJAYA CLINIC & LIFE STYLE @
OKTROI KEMANG
OKTROI PLAZA, MEDICAL MEZZANINE
LT. 3 JL. KEMANG UTARA RAYA NO. 1
JAKARTA SELATAN
IBU RIKE - 021 - 7197580/ 71792101| 021 - 71792074 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
311 2418 KLINIK DENTIST AND DENTINSJL. WOLTER MONGONSIDI NO.58 C
JAKARTA SELATANBPK FACRUL - 0217210480| -- N Y Y PARTIAL DENTAL
312 2341 KLINIK AJI WARAS CILANDAK
JL. CILANDAK KKO NO.45A, RAGUNAN,
PASAR MINGGU, JAKARTA SELATAN
12550
IBU RUSTINI/DRG
ESTHERKoordinator (021) 78836308; 78835703| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
313 2356MAYAPADA HOSPITAL JAKARTA
SELATAN (MHJS)
JL. LEBAK BULUS I KAV. 29, JAKARTA
SELATANIBU SHINTHA Marketing 021-29217777| 021-29216666 Y Y Y ACTIVE ALL COVERAGE
febrina.shintha@mayapadahospi
tal.com
314 2379 DRG. ANGGRAENI
JL. PALAPA I NO. 4 KOMPLEK
PERTANIAN PASAR MINGGU JAKARTA
SELATAN 12520
DRG ANGGRAENI - 021-7806291| 021- 7806291 N Y Y PARTIAL DENTAL -
315 2641 KLINIK & APOTEK KF 42JL. ST. HASANUDDIN NO.1
KEBAYORAN BARU JAKARTA SELATAN
DRS. I WAYAN
BUDHI
ARTHAWAN,APT
- 021 7220292| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
316 0049 RS. PONDOK INDAHJL. METRO DUTA, KAV. UE, PONDOK
INDAHIBU DETTY MARKETING 021-7657525| 021-7502324 Y Y Y ACTIVE ALL COVERAGE
benjamin.baldwinromanda@rspo
ndokindah.co.id
317 1089RS. KHUSUS THT & BEDAH
CIRANJANGJL. CIRANJANG NO.20-22 KEB.BARU IBU TIKA MARKETING
021-
7243366/7208192/7208192
|021-7208192
021-7264038 Y Y Y ACTIVE ALL COVERAGE [email protected]
318 1554 H2E DENTAL CLINIC
MENARA KUNINGAN,JL. HR. RASUNA
SAID BLOCK X-7 LT1. UNIT I,
KUNINGAN
DR. EFINDY MARKETING 021-30040151/152| 021-30040152 N Y Y ACTIVE ALL COVERAGE [email protected]
319 1574 DE BLITZR DENTAL CARE II
WISMA ARGO MANUNGGAL LT. 1 JL.
GATOT SUBROTO KAV. 22 JAKARTA
SELATAN
IBU HANIManager
Pemasaran021-2520124| 021-2522014 N Y Y PARTIAL DENTAL
320 1458MULIA HEALTH AND DENTAL CARE
(MHDC)
GEDUNG MENARA MULIA, SUITE LG, JL.
JEND.GATOT SUBROTO, KAV.9-11DRG.MAEMUNAH ALI - 021-5223838| 021-52901073 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
321 0799 RS. GANDARIAJL. GANDARIA TENGAH II, NO.12-14,
KEBAYORAN BARU
IBU FEMI DAN IBU
LISMARKETING 021- 7250718/ 7203311| 021- 7222038 Y Y Y ACTIVE ALL COVERAGE [email protected]
322 0800 KLINIK TRIAZ PERSADAGRAHA NIAGA TOWER LT.B1, JL. JEND.
SUDIRMAN NO.58IBU NURHASAH KOORDINATOR 021- 2505250| N Y Y ACTIVE ALL COVERAGE [email protected]
323 0193 RSIA. BUDHI JAYA JL. DR. SAHARJO, NO.120IBU RETNO, IBU
CHRISMARKETING
021-8292672/8311722021-
8311722|021-8311722021-8301901 Y Y Y ACTIVE ALL COVERAGE [email protected]
324 0890 KLINIK INTERMED HEALTH & BEAUTYJL. KEBAGUSAN 1 NO. 8 JAKARTA
SELATAN 12520IBU LANI MARKETING 021-7823501| 021-7823502 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
325 1708KLINIK YAKES MANDIRI-PLAZA
MANDIRI
PLAZA MANDIRI LT. BASEMENT I, JL.
JEND GATOT SUBROTO KAV 36-38BP SLAMET WIYONO - 021-5245351, 5245351| 021-5245351 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
326 1872 KLINIK TRIHATI PLUSRUKAN ROYAL PALACE BLOK A5, JL.
PROF DR SOEPOMO SH NO 1IBU. RIA MARKETING 021-829 9119| 021-8299113 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected]/marketin
327 1942 KLINIK & APOTEK KF 47JL. RADIO DALAM RAYA 1-5, JAKARTA
SELATAN- - 021-7208735| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
328 1944 KLINIK & APOTEK KF 152JL. RAYA PASAR MINGGU KM 18
JAKARTA SELATANIBU ELISABETH Marketing 0217943222| 021-7943223 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
329 0842BRAWIJAYA WOMEN & CHILDREN
HOSPITAL
JL. TAMAN BRAWIJAYA NO.1 CIPETE
UTARAIBU WIWIN MARKETING 021 - 7211337| 021 - 7211364 Y Y Y ACTIVE ALL COVERAGE [email protected];
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 12 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI330 0853 RB & KLINIK PRIMA HUSADA CINERE
JL. CINERE RAYA BLOK F1 NO.1
CINERE JAKSEL
DR. DESMAN / IBU
MAURI SARAGIKOORDINATOR 021-7546263/7547382| 021-7540062 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
berkah_prima_husadatama@yah
oo.co.id
331 0879 RSU. YADIKA CIPUTATJL. CIPUTAT RAYA, NO.5, KEBAYORAN
LAMAIBU.ERNA MARKETING 021-7291074| 021-72895046 Y Y Y ACTIVE ALL COVERAGE [email protected]
332 0593 RS. SETIA MITRAJL. RS. FATMAWATI, NO.80-82,
CILANDAKIBU TARI/PUJI MARKETING
021-
7656000/7651021/7654676
|
021-
7656880/7656875Y Y Y ACTIVE ALL COVERAGE [email protected]
333 0999RSU. MUHAMMADIYAH TAMAN
PURING
JL. GANDARIA I NO.20 KEBAYORAN
BARU
DRG. LUKMAN / IBU
CITRAMARKETING
021-
7229623/7250243/7208358
021-7208358|021-7208358
021-
7234823/7210516Y Y Y ACTIVE ALL COVERAGE [email protected]
334 0957KLINIK PETUKANGAN MEDICAL
CENTREJL. CILEDUG RAYA NO.8A BU. RITA Sekretariat 021-7340906-|- 021-73889956 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected] atau
335 0972 RSIA. AULIAJL. JERUK RAYA NO 15 JAGAKARS. A,
JAKARTA SELATANIBU HAURA Marketing 021-7270208-|- 021-7866057 Y Y Y ACTIVE ALL COVERAGE
marketing.rsiaaulia@gmail
336 1408 BIDAKARA MEDICAL CENTER (BIMC)
GEDUNG BINA SENTRA, LT.DASAR,
KOMP.BIDAKARA, KAV.71-73,
PANCORAN
IBU . JUWITA MARKETING 021-83783535/83783636| 021-83785349 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
337 1412 APOTIK FARMARIN III BIDAKARA
GED. BINASENTRA KOMP. BIDAKARA
JL. GATOT SOEBROTO KAV. 71 - 73
JAKARTA
ARI
PRIHANTINI/IBU.
SANTI
KOORDINATOR 021 - 83704414| 021 - 83793006 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
338 1424 RSB. ASIHJL. PANGLIMA POLIM I NO.34 JAKARTA
SELATAN 12160
IBU INDY/ IBU NING
BANGUN
MARKETING DAN
HUMAS021-2700609-10| - Y N Y ACTIVE ALL COVERAGE [email protected]
339 1076 KLINIK YADIKA PETUKANGANJL. DAMAI RAYA NO.1 PETUKANGAN
SELATAN - JAKARTA SELATANDR.ROS INTAN
PENANGGUNG
JAWAB021-7370881-|- 021-73887810 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
340 1083 RS. MATA AINIJL. H.R.RASUNA SAID (KUNINGAN)
JAKARTA
IBU NOVI/IBU
SRI/IBU
KIKI/ZR.UTIN
ADM RI021-5256228/5203866021-
5203866|021-5203866
021-
5265618/5224288Y Y Y ACTIVE ALL COVERAGE [email protected]
341 1546 KLINIK NDH (RAJA SERVICE) JL. RADIO DALAM RAYA, NO.54A DRG.NINA DELI KOORDINATOR 021-7257244| 021-7257244 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
342 0112 SUDIRMAN MEDICAL CENTER JL. KARET BELAKANG TIMUR NO. 17 IBU EKA MARKETING 021-5203467/96277627| 021-5203468 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
343 0110 RS. TRIA DIPAJL. RAYA PASAR MINGGU, NO.3A,
PANCORAN
BPK. DEDE/ IBU
WITAMARKETING 021-7993058,7974071-73| 021-7974074 Y Y Y ACTIVE ALL COVERAGE
344 0034 ADITYA MEDICAL CENTERJL. ADITYAWARMAN I, NO.14,
KEBAYORAN BARU
DR.OKKI/IBU
YANTI/ITA
KEUANGAN/KOOR
DINATOR021-7228639| 021-7228922 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
345 0041 RS. AGUNGJL. SULTAN AGUNG, NO.67, PASAR
RUMPUTIBU WITA/PUJI MARKETING
0218294955,8305768/9,828
2795,83794207|021-8305791 Y Y Y ACTIVE ALL COVERAGE
346 0795 RS. PUSAT PERTAMINA JL. KYAI MAJA 43, KEBAYORAN BARU MARDALENA Marketing (021) 7219204/7219700| (021) 7203540, Y Y Y ACTIVE ALL [email protected];ros
347 0199 MEDICARE CLINIC
MENARA KADIN INDONESIA, 27TH
FLOOR, JL. H.R. RASUNA SAID, BLOK X-
5, KAV.2-3
BPK. HERRY
SETIAWANMARKETING 021-57903905| 021-5274754 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
348 0775 RSB. DUREN TIGAJL. DUREN TIGA RAYA, NO.5,
PANCORANIBU TIKA / LIA
MARKETING /
PIUTANG021- 794 1843| 021- 790 1050 Y Y Y ACTIVE ALL COVERAGE [email protected]
349 0794 RS. SIAGA RAYAJL. PEJATEN BARAT KAV.4-8, PASAR
MINGGU, JAKARTA SELATANIBU SHEILA MARKETING 021- 7972750| 0217970627/6 Y Y Y ACTIVE ALL COVERAGE [email protected]
350 0401KLINIK SPESIALIS & APOTIK, RSB.
ESTI
JL. BANGKA RAYA, NO.28-30, PELA
MAMPANGBPK TEVI GUNAWAN MARKETING 021-7194434-35| 021-71791917 Y Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected]/market
351 0892 KLINIK FAMILY DENTISTRY JL. PANGLIMA POLIM II/2DRG S.ADI
WIRADIDJAJAKoordinator 021-7267267-|- 021-7264365 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
352 0395 RS. PRIKASIHJL. RS. FATMAWATI, NO.74, PONDOK
LAB. U - CILANDAKBPK AANG MARKETING
021-
7501192/7504669/7590117
4021 - 7504669|021 -
7504669
021-7505148 Y Y Y ACTIVE ALL COVERAGE [email protected]
353 0400 MEDIKALOKA HEALTHCARE CENTERJL. HR. RASUNA SAID, BI X-1,
KUNINGANBPK.NINO MARKETING 021-5261118| 021-5261119 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
354 0758 DE BLITZR DENTAL CARE
BELLEZZA SHOPPING ARCADE UNIT
230-231ARTERI PERMATA HIJAU,JL.
LETJEND SOEPENO NO.34
IBU HANI/FIKA KOORDINATOR 021-53664742| 53664743 N Y Y PARTIAL DENTAL [email protected]
355 0003 RS. TEBET JL. MT. HARYONO, NO.8, PANCORAN IBU.YATI MARKETING 021-8307540 / 829154| 021-8311760 Y Y Y ACTIVE ALL [email protected]/m
JAKARTA TIMUR
356 0024 KLINIK PRIMA HUSADA CIBUBURJL. LAPANGAN TEMBAK NO.2A
CIBUBUR
BPK. FAJAR DARS.
ONOKEUANGAN
021-
8708024/98111938/911193
8021-9111938|021-
9111938
021-87707503 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 13 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI357 0258 KLINIK DEVITA
JL. JATINEGARA TIMUR NO.57
JATINEGARADR. RUDI SUPRAPTO KEUANGAN
021-819 6260021-819
6041|021-819 6041
021-
85906901/851627
4
N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
358 0292 KLINIK PONDOK GEDE AGUNGJL. RAYA HANKAM, NO.58C-D, PONDOK
GEDEIBU ANJANI ADMINISTRASI 021-8464030| 021-8463803 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
om
359 0286 RS. KARTIKA PULO MAS JL. PULO MAS TIMUR K BLOK G-H-C/1 IBU. RAHAYUHUMAS &
MARKETING
021-4703333021-470
3333|021-470 3333021-4723402 Y Y Y ACTIVE ALL COVERAGE [email protected]
360 0806 RS. HAJI JAKARTA JL. RAYA PONDOK GEDENARIARTI HARDINI
(DINI)Div. Marketing
(021) 8000693-95(021)
8000695|(021) 8000695
021-
80876175/800015
2
Y Y Y ACTIVE ALL [email protected];am
361 0805 RSU. UKI JL. MAYJEN SOETOYO, CAWANG IBU PENI MARKETING
021-
8092317,8010526,8092831,
8010523|
021-
8092445/8005595Y Y Y ACTIVE ALL COVERAGE
362 0807 KLINIK MHT TEGALAN JL. TEGALAN NO. 30 DR INDAH KOORDINATOR 021-8581344| 021-8581344 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
363 0779 RS. AU DR.ESNAWAN ANTARIKSAJL. MERPATI NO.2 LANUD HALIM
PERDANAKUSUMA
KAPT.BUDI
SANTOSOHUMAS (021) 8007027| (021) 8098 665 Y Y Y ACTIVE ALL COVERAGE
364 0382RB & KLINIK 24 JAM MHT PONDOK
GEDE D/H RS PONDOK G
JL. RAYA PONDOK GEDE, NO. 23-25,
KRAMAT JATIIBU HENNY MARKETING
021-
8093602/80887175/74|021-
80887175
021-80887174 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
[email protected]/yanee_
365 0652 RB & KLINIK AL - FAUZANJL. RAYA CONDET NO.13,
BALEKAMBANG CONDETBPK. FAIZ/ IBU PUR MARKETING 021-80886224| 021-8096968 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
366 0749 RS. HARUM SISMA MEDIKAJL. TARUM BARAT, KALIMALANG
JAKTIMTARTO/ RATNA
MARKETING/KEUA
NGAN
021-8617212/3021-
8617213|021-8617213021-8601030 Y Y Y ACTIVE ALL COVERAGE [email protected]
367 0826 RB & KLINIK SEJAHTERA CIRACAS JL. RAYA CIRACAS NO.7 BPK.TURYANTO Humas
021-
87717635/87712710/87712
711-|-
021-87720232 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
368 2142 KLINIK PERTAMEDIKA RAWAMANGUN JL. MUNDU RAYA NO.1 JAKARTA TIMUR IRMA - 021-4894150| 021-4894278 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
369 1244 RS. MASMITRAJL. KELURAHAN JATIMAKMUR, NO.40,
PONDOK GEDEIBU WIWIT MARKETING 021-84971766| 021-8483047 Y Y Y ACTIVE ALL COVERAGE
370 2826 RS. COLUMBIA ASIA PULOMASJL. KAYU PUTIH RAYA, PULOMAS -
JAKARTA TIMUR 13210
ALI SABRI (021)
29559411 ; (0812
3850 2054)
MARKETING (021) 2945 9999| (021) 2955 9477 Y Y Y ACTIVE ALL COVERAGE [email protected]
371 3533 KLINIK MEDIKA PRAKARSAJL. RADEN INTEN II DUREN SAWIT,
JAKARTA TIMURBAPAK BAIHAQI MARKETING (021) 86908103| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
@medikaprakarsa.co.i
372 0102RS. ISLAM JAKARTA TIMUR (PONDOK
KOPI)JL. RAYA PONDOK KOPI
IBU ALIUS/ BPK
ANGGORO
HUMAS/KEUANGA
N
021-8630654/8610471021-
8610471|021-8610471021-8611101 Y Y Y ACTIVE ALL COVERAGE [email protected]
373 1080 RS. KESDAM CIJANTUNGJL. MAHONI NO.1, CIJANGTUNG II
PASAR REBO JAKARTA TIMURBPK EGI ADM PERUSAHAAN
021-
8407886/8400535/8779333
2-|-
021-87793332 Y Y Y ACTIVE ALL [email protected]
om
374 2643 KLINIK & APOTEK KF 49JL. P. REVOLUSI 53, PD. BAMBU,
JAKARTA TIMUR
ANISA IKA
RAHMANIAH,
S.FARM., APT.
- 021 861-5154| 021-8612721 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
375 3980 KLINIK & APOTEK KF 48JL. MATRAMAN RAYA NO 55 JAKARTA
TIMURWAYAN SUTAKA - 0818810414| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
376 3981 KLINIK & APOTEK KF LAP.TEMBAKJL. LAWU B1 NO.1 CIBUBUR LAPANGAN
TEMBAK CIBUBURNASTIA HIDAYATI - 08128737346| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
377 3531 SUMATERA EYE CENTER JAKARTAJL. PEMUDA NO. 36, RAWAMANGUN,
JAKARTA TIMUR
CITRA KARINA
PUSPITA LOKAMARKETING (021) 4714848| (021) 4755703 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
378 1932 APOTEK KIMIA FARMA 193JL. UTAN KAYU NO 105 P JAKARTA
TIMURROSMIDA KHOHAR APOTEKER 021-8520808| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
379 1933 APOTIK FARMARIN II PENGGILINANPERUM TAMAN PULO INDAH BLOK I
NO.7-8 PENGGILINGAN CAKUNGIBU NILA/ SUPRI - 021-4800688| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
380 2251 RS. ANTAM MEDIKAJL. PEMUDA RAYA NO 1A PULOGADUNG
JAKARTA TIMUR
IBU SRI AGUSTI
NINGSIHmarketing 021- 29378939/40/44| 021- 29385160 Y Y Y ACTIVE ALL COVERAGE [email protected]
381 2141KLINIK PERTAMEDIKA MEDAN
SATRIA
JL. ARUN IX NO. 2 MEDAN SATRIA
CAKUNG JAKARTA TIMUR 17132KIKI SM - 021-4604944| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
382 2391 RS. JANTUNG JAKARTAJL. MATRAMAN RAYA NO.23, JAKARTA
TIMUR
SUCI
TRIHANDAYANI-
021-
29361158/29361160/29360
698|
2129361158 Y Y Y ACTIVE ALL COVERAGE [email protected]
383 2620 KLINIK & APOTEK KF 4 JL. PERSERIKATAN 7-8, RAWAMANGUN
RUMONDANG
MARIA, S.FARM.,
APT.
- 021 471-8059| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 14 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI384 2638 KLINIK & APOTEK KF 147 JL. DUREN SAWIT
DRS. ADI
SUPRIYADI, APT.- 021 861-5458| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
385 1490 RSIA. BUNDA ALIYAHJL. PAHLAWAN REVOLUSI NO.100
PONDOK BAMBU
IBU ENDANG/PAK
SANDYMARKETING 021-86602525| 021-86600712 Y Y Y ACTIVE ALL COVERAGE
marketing.rsiabundaaliyah@gma
il.com
386 0060 RS. HARAPAN BUNDA JL. RAYA BOGOR KM.22 NO.44 ITA/ENDAH MARKETING 021-8400257|
021-
8412977/8778020
1
Y Y Y ACTIVE ALL [email protected]
m
387 0888 RS. YADIKA PONDOK BAMBUJL. PAHLAWAN REVOLUSI NO.47
PONDOK BAMBU - JAKARTA TIMURIBU TETTY MARKETING
021-8615754021-
8610756|021-8610756021-8613332 Y Y Y ACTIVE ALL COVERAGE
388 0289 RS. OMNI MEDICAL CENTER JL. PULO MAS BARAT VI, NO.20 BPK. AMRI MARKETING 021-4723332,4722719|021-
4718081,4708180Y Y Y ACTIVE ALL COVERAGE
mktpulomas@omni_hospitals.co
m;
389 0012RS. PREMIER JATINEGARA ( RS
MITRA INTERNASIONAL)JL. RAYA JATINEGARA TIMUR, NO.85-87 IBU RENI/drg. widya MARKETING
021-2800666/2800888|021-
2800777021-2800755 Y Y Y ACTIVE ALL COVERAGE
rspremier.jatinegara@ramsayhe
alth.co.id;
390 1868RSIA. AL-FAUZAN (JAKARTA ISLAMIC
HOSPITAL)
JL. PEDATI NO 3 RT 5 RW 7, KAMPUNG
TENGAH KRAMAT JATIIBU NIA MARKETING 021-87780318| - Y Y Y ACTIVE ALL COVERAGE
m
391 1843 RSIA. SAYYIDAHJL. TAMAN MALAKA SELATAN NO. 6
PONDOK KELAPA, JAKARTA TIMUR
BPK RAMA/ BPK
BERTOMARKETING (021) 8690 2950| (021) 864 9886 Y Y Y ACTIVE ALL COVERAGE
392 1012 KLINIK IBIN SINAJL. PENDIDIKAN RAYA NO.33 DUREN
SAWITIBU DEWI MARKETING
021- 866 03270, 866
1669021-86603270|021-
86603270
86601611 N Y Y ACTIVE ALL COVERAGE [email protected]
393 0944RS. BHAYANGKARA TK.1 R.SAID
SUKANTO (POLRI)JL. RAYA KRAMAT JATI IBU RATNA MARKETING 021-8093288-|- 021-8094005 Y Y Y ACTIVE ALL COVERAGE
394 0948 KLINIK SAPTA MITRAJALAN TAMAN MALAKA UTARA BLOK
A12, MALAKAJAYABAPAK DEDI MARKETING
021-86906363021-
5844330|021-5844330021-86906363 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
marketing_saptamitraklinik@yah
oo.co.id
395 0099 RS. HARAPAN JAYAKARTAJL. BEKASI TIMUR RAYA, NO.6 KM.18,
PULO GADUNGIBU LISA MARKETING
021-4603916/4601371021-
46822879|021-46822879021-4608863 Y Y Y ACTIVE ALL COVERAGE
396 0386 RSIA. HERMINA JATINEGARA JL. RAYA JATINEGARA BARAT, NO.126 IBU DESY MARKETING021-8191223021-
8504371|021-8504371021-8190111 Y Y Y ACTIVE ALL COVERAGE
jatinegara@herminahospitalgrou
p.com
397 1001 RS. DHARMA NUGRAHAJL. BALAI PUSTAKA BARU NO.19
RAWAMANGUNRANI ADM
021-4707433-37021-
4707437|021-4707437021-4707429/8 Y Y Y ACTIVE ALL COVERAGE
398 1139 KLINIK TJAKRAJL. RAYA BOGOR, KM.24, NO.35,
SUSUKAN CIRACASBPK.ANGGA MARKETING 021-8401677|
021-
87792558/840167
7
N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected];tribudi63
@yahoo.co.id
399 1192 KLINIK & APOTEK PUTEWAJL. NUSA INDAH RAYA BLOK 40
NO.17HIBU LATIVA ADM 021-8622207/70302043| 021-8622207 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
400 0962 KLINIK CONDET JAYA JL. CONDET JAYA NO.18 BATU AMPARIBU SUSI/BAPAK
WARNOMARKETING 021-8090712|- 021-80881275 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
401 0990RS. JANTUNG BINA WALUYA
CARDIAC CENTERJL. TB SIMATUPANG NO.71 IBU SIFA MARKETING
021-87781605-06021-
87781606|021-87781606021-8403869 Y Y Y ACTIVE ALL COVERAGE
402 1110 RSIA. RESTI MULYAJL. PAHLAWAN KOMARUDIN RAYA NO. 5
PENGGILINGAN CAKUNGBPK. ABDILAH MARKETING
021-4803936-4802192-
4803707|021-48701488 Y Y Y ACTIVE ALL COVERAGE
403 1212 KLINIK BINA HUSADA BHAKTIJL. PENGGILINGAN RAYA NO.1
RT.01/07 CAKUNG
BPK.WAWAN/IBU
INDRIMARKETING 021-46829425| 021-46829425 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
o.id
404 1217 RSIA. RESTU KASIHJL. RAYA BOGOR, KM.19, NO.3A,
KRAMAT JATI
IBU OKTAVIA
LINGGAR
PIMPINAN/KOORDI
NATOR021-8002166/8001177| 021-80882753 Y Y Y ACTIVE ALL COVERAGE [email protected]
405 1096 KLINIK YADIKA CIBUBURJL. LAPANGAN TEMBAK NO.9 PEKAYON-
CIBUBURIBU RINI MARKETING 021-8711515-|- 021-8711515 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
406 1258 KLINIK SUCI HUSADAJL. SUCI NO.21 RT.08/06 SUSUKAN -
CIRACASDR.EDDY PEMILIK 021- 87798796| 021- 87798796 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
407 1262 RS. RAWAMANGUN JL. BALAI PUSTAKA RAYA, NO.29-31 BPK. RIZAL MARKETING 021-4893531| 021-4710918 Y Y Y ACTIVE ALL COVERAGE [email protected]
408 1538KLINIK MITRASANA (DANKOS
FARMA)
JL. RAWA GATEL, BLOK IIIS, KAV.37-
38, KAW.INDUSTRI PULO GADUNGIBU HELDA KOORDINATOR 4600158/4600157| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
409 1499 RB & KLINIK ANNISA CIRACAS JL. CIRACAS NO.18 IBU BETRIDA / KOORDINATOR 021-87720807| 021-87717636 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
410 0122 RS. MEDIROS JL. PERINTIS KEMERDEKAAN, KAV.149BPK UKAS/IBU TIA
/ BPK RAHMANMARKETING
021-
4750042/4897415/4893036
/4895817/4721237021-
4893036|021-4893036
021-4891937 Y Y Y ACTIVE ALL [email protected]/rs-
JAKARTA UTARA
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 15 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI411 3998 KLINIK PESONA TANAH PASIR
JL. TANAH PASIR RUSUN PENJARINGAN
BLOK MAWAR I A
KEL.PENJARINGAN,KEC.PENJARINGAN,
JAKARTA UTARA
DR. EDDY OWNER021-
66675691/085101280470|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
412 0170 RS. PLUIT JL. RAYA PLUIT SELATAN, NO. 2IBU MIAN/BPK
TAUFIK/DR.JOVITAMARKETING
021-6685006; 021-
668507|021-668507021-6684878 Y Y Y ACTIVE ALL COVERAGE
humas_marketing@pluit/marketi
413 2143 KLINIK PERTAMEDIKA DELIJL. DELI NO. 22 JAKARTA UTARA - 1-
628
SYAHRUL
(081511520327)- 021-43923390 / 3389| 021-4353461 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
414 4079 RS. DUTA INDAH JL. TELUK GONG RAYA NO 12 WISNU PRABOWO - (021) 666 7 6188| (021) 6667 6190 Y Y Y ACTIVE ALL COVERAGE [email protected]
415 1946 APOTEK KIMIA FARMA 46 JL. YOS SUDARS. O, JAKARTA UTARA - - 021-4393397| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
416 2412 KLINIK BERSALIN LESTARI
JL. MANGGAR NO.141 KEL.LAGOA,
KEC.KOJA TANJUNG PRIOK JAKARTA
UTARA
BAMBANG - 021 43922950| - N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
-
417 2458 RSIA. GRAND FAMILY
JL. PANTAI INDAH SELATAN 1,
KOMPLEK ELANG LAUT BOULEVARD
KAV.1 NO.1, PENJARINGAN - JAKARTA
UTARA
IBU MYLLA
NASUTION-
021-
296333777/02129673737
DAN 29678062|
- Y Y Y ACTIVE ALL COVERAGEmylla.nasution@rsiagrandfamily.
com
418 2506 MITRASANA KELAPA GADING
JL. BOULEVARD TIMUR RAYA BLOK NB
I NO 36 KELURAHAN PEGANGSAAN
DUA, KELAPA GADING JAKARTA UTARA
- - 021-36464908/4585455| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
419 1550 RS. PURI MEDIKAJL. SUNGAI BAMBU RAYA, NO.5,
TANJUNG PRIOK
BPK SUBHAN/IBU
DINAMARKETING 021-43903355/43931975| 021-43903388 Y Y Y ACTIVE ALL COVERAGE [email protected]
420 1677KLINIK SOLA GRACIA MEDICAL
CENTER
JL. SUNTER AGUNG UTARA BLOK A 17
D NO 1DRG. BETTY PEMILIK 021-6459530/6452041|
021-6459530;
6451274N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
421 1746 LAB. KLINIK BIOTEST PLUITJL. PLUIT SAKTI RAYA NO 25 JAKARTA
UTARAVIVI/RATRI - 021-6622611| 021-6628166 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
422 1644 KLINIK SYIFA MEDICAL CENTREJL. LONTAR LUAR NO.7 RT 004/04
TUGU UTARA KOJAIBU NURUL MARKETING 021-43935260| 021-43935375 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
423 0876 RSIA. FAMILY
JL. PLUIT MAS I BLOK A NO.2A-5A,
KOMPLEK PERUMAHAN PLUIT MAS,
JAKARTA UTARA
IBU RERE MARKETING021-6695066/6694990021-
6694990|021-6694990
021-
6615563/6660725
4
Y Y Y ACTIVE ALL [email protected]/
424 1033 RS. PORT MEDICAL CENTER JL. ENGGANO NO.10 TANJUNG PRIOK IBU RIZKA MARKETING 021-43902350/43902351-|- 021-43902302 Y Y Y ACTIVE ALL COVERAGE [email protected]
425 0919 RS. PELABUHAN JAKARTA JL. KRAMAT JAYA, TANJUNG PRIOK DR.SELVI MARKETING 021-4403026|021-4403026021-
4403551/4406886Y Y Y ACTIVE ALL COVERAGE [email protected]
426 0392 RSIA. HERMINA PODOMOROJL. DANAU AGUNG 2, BLOK E3, NO.28-
30, SUNTER AGUNG, PODOMOROIBU KRISTIN/ENI MARKETING 021-6404910/911| 021-6518720 Y Y Y ACTIVE ALL COVERAGE
podomoro@herminahospitalgrou
p.com
427 0587 RS. SATYA NEGARA JL. AGUNG UTARA RAYA, BLOK A, NO.1DR. TONI
081399999870Marketing
021-64715200021-687813-
14/6|021-687813-14/6021-6877813 Y Y Y ACTIVE ALL COVERAGE
ytiadr.satyanegara@gma
428 1263 KLINIK SEMPER SISMA MEDIKAJL. KESEMEK, NO.3-5, SEMPER BARAT,
CILINCINGBPK. AHYAT Kep Adm & Keu 021- 4400902/4403101| 021-4403101 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
429 1269 RS. MULYASARIJL. RAYA PLUMPANG SEMPER NO. 19
JAKARTA UTARADR. RIANA ZULFA
KABAG BID.
PELAYANAN
021-43931111-43936666-
43939999|
021-
43934369/8888Y Y Y ACTIVE ALL COVERAGE
430 1422 ROYAL PROGRESS INT HOSPITALJL. DANAU SUNTER UTARA, SUNTER
PARADISE IIBU NEVI
SALES
KOORDINATOR021- 6400261| 021-6519534 Y Y Y ACTIVE ALL COVERAGE [email protected]
431 0186RS. MITRA KELUARGA KELAPA
GADING
JL. BUKIT GADING RAYA KAV.2 KELAPA
GADING PERMAI
DR. ANNY
ALFIANTI/IBU
MAYA/IBU DELLA
MARKETING 021-45852700|
021-
45852727/458540
4
Y Y Y ACTIVE ALL [email protected];keua
ngankg@mitrakeluarga.
432 0812 RS. ATMA JAYA JL. PLUIT RAYA NO.2 IBU HAPPY MARKETING (021) 6606127| (021) 6606122 Y Y Y ACTIVE ALL COVERAGEmarketingpr@atmajaya-
hopital.co.id
433 0811 RS. SUKMULJL. TAWES NO.18 - 20, TANJUNG
PRIOKIBU YUNI/ BP PINTO MARKETING 021- 4301269| 021- 4301272 Y Y Y ACTIVE ALL COVERAGE [email protected]
434 0396 RS. PANTAI INDAH KAPUKJL. PANTAI INDAH UTARA 3, PANTAI
INDAH KAPUK
IBU
DESAK/NELLA/FITRI
MARKETING/ASUR
ANSI021-5885066; 5885065|
021-
5880910/5881091Y Y Y ACTIVE ALL COVERAGE [email protected]
435 0882 RS. ISLAM JAKARTA UTARAJL. TIPAR CAKUNG NO.5 JAKARTA
UTARA
IBU DINA/DRG.
RENITAMARKETING
021-4400781,4400778021-
4400778|021-4400778
021-
44832228,440078
2
Y Y Y ACTIVE ALL COVERAGE [email protected]
GORONTALO
436 1420 RSIA. SITTI KHODIJAH GORONTALOJL. NANI WARTABONE NO. 101 d/h JL.
AHMAD YANIIBU NURHAYATI MARKETING
0435-821258/0435-
821253/0435-824410|0435-824410 Y N Y ACTIVE ALL COVERAGE [email protected]
JAMBI
437 2207 RSU. BAITURRAHIM JAMBIJL. PROF. M. YAMIN SH NO. 30 LEBAK
BANDUNG - JAMBIIBU RINI PROVITA Marketing
0741-35165/0741-
5911096/97/98|0741-5911099/97 Y Y Y ACTIVE ALL COVERAGE
id; rsu_baiturrahim@y
GORONTALO
JAMBI
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 16 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI438 2047 RSIA. ANNISA JAMBI
JL. KABIA NO 04 RT 01 KEL. KEBUN
HANDIL KEC JELUTUNG KOTA JAMBIM. SALEH - (0741) 445226| - Y Y Y ACTIVE ALL COVERAGE [email protected]
439 0894SILOAM HOSPITALS JAMBI (D/H RS.
ASIA MEDIKA)
JL. SOEKARNO - HATTA, PAALMERAH
JAMBI
BP TUNGGUL PURB.
AMARKETING 0741-5919000-|-
0741-
573271/573238Y Y Y ACTIVE ALL COVERAGE
Tunggul.Purba@siloamhospitals.
com
440 2184 APOTEK KIMIA FARMA 208 JL. SOEMANTRI BROJONEGORO NO. 1BPK. MURS. YID
(APOTEKER-
08877800501/08214638327
5|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
441 1641 RS. ISLAM ARAFAHJL. EMPU GANDRING NO.1 KEBUN
JERUK, JAMBI
IBU DELLA/ IBU
ICHAMARKETING 0741-62711/667966/62177| 0741-63444 Y Y Y ACTIVE ALL COVERAGE [email protected]
442 0550 RS. ST.THERESIA JL. SUTOMO, NO.19
IBU
RENDA/BPK.YOHANE
S/IBU HERTI
KEUANGAN 0741 - 23119 / 7553811| 0741-20832 Y Y Y ACTIVE ALL [email protected];
MUARA BUNGO
443 1926 RS. SENTRAL MEDIKA MUARA BUNGOJL. RANGKAYO HITAM, CADIKA MUARA
BUNGO, JAMBIUMI MARKETING 0747-22207/22209| 0747-22209 Y Y Y ACTIVE ALL COVERAGE [email protected]
BANDUNG
444 0761 RS. SANTO BORROMEUS BANDUNG
JL. IR. H. JUANDA NO. 100 LEBAK
GEDE COBLONG BANDUNG JAWA
BARAT, INDONESIA
IBU RIA/
ESKARINA/IBU DEVI
/ IBU KARIN/ DWI
TANIA
MARKETING
022 2552166/022-
2552083/95022-
2552003|022-2552003
022-2504235 Y Y Y ACTIVE ALL COVERAGE [email protected]
445 1125 RS. CAHYA KAWALUYANJL. PARAHYANGAN KM.3 KAV.HOS
PADALARANG
IBU ERLINAWATI/
MERRYMARKETING 022-6803700|
022-
6803711/6803730Y Y Y ACTIVE ALL COVERAGE
[email protected]/rlint
446 2950 RS. KB. MELINDA II
JL. CIPTO NO. 1 RT 05/02, KEL.
PASIRKALI KEC. CICENDO, KOTA
BANDUNG
BAPAK REMY - 022-4267888/4233777| 022-4247888 Y Y Y ACTIVE ALL COVERAGE [email protected]
447 3001 LAB. KLINIK BIOTEST NARIPAN JL. NARIPAN NO. 41 BANDUNG IBU YAYAH MARKETING (022) 4205544| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
448 1211 KLINIK ASRI HUSADA II JL. TITIRAN NO.16 DR.YONO PIMPINAN 022-2507293| 022-2507293 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
449 1169 RS. AMC (ANNISA MEDICAL CENTER) JL. RAYA CILEUNYI RANCAEKEKIBU DARA / IBU
DEWIMARKETING
022-
7781630,70804777,708057
77|
022-
70804777/778162
9
Y Y Y ACTIVE ALL [email protected]/www.amc
hospital.blue.orb.biz
450 1171SANTOSA BANDUNG INTERNASIONAL
HOSPITALJL. KEBON JATI, NO.38
MIRA/ANDRI/MIRZA
/MARKETING 022-4248333|
022-
4211086/8446859
8
Y Y Y ACTIVE ALL COVERAGEandri_subekti@santosa-
hospital.com
451 0958 KLINIK AN-NUR JL. DR. SETIA BUDI NO.63 IBU YOSI MARKETING 022-2031922-|-022-
2031922/2042213N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
452 0959 KLINIK ASRI HUSADA I JL. BEKAMIN NO.18 BPK.SURYADI KOORDINATOR 022-7230425-87245792|- 022-2507293 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
453 1088 RS. RAJAWALI JL. RAJAWALI NO.38 BPK. SOFYAN ADMINISTRASI022-6031087, 6011913,
6079143,6051087-|-022-6032077 Y Y Y ACTIVE ALL COVERAGE [email protected]
454 1093RS. KHUSUS BEDAH HALMAHERA
SIAGAJL. LL.RE MARTADINATA NO.28
BESTI YULIANA
S.KM
Humas dan
Marketing
022-
4206061/70858254/421643
6-|-
022-4236920 Y Y Y ACTIVE ALL COVERAGE [email protected]
455 0145 RS. MUHAMMADIYAH BANDUNG JL. KH. AHMAD DAHLAN NO.53 BPK.WAWAN MARKETING
022-
7301062,7312167,7323549,
7306935,7323548|
022-7306458 Y Y Y ACTIVE ALL COVERAGE
rsmuhammadiyahbandung53@y
a
456 0886 RSUD. AL IHSAN JL. KIASTRAMANGALA, BALEENDAH,
IBU
DEUCE/BPK.SUTISN
A
HUMAS &
PEMASARAN
022-
5940872/5941719/5941729
022-5941719|022-5941719
022-5941709 Y Y Y ACTIVE ALL COVERAGE [email protected]
457 0877 KLINIK & APOTEK KIMIA FARMA 10 JL. BRAGA, NO.2-4-6BPK.MURS. YID/ IBU
YULIANISEKRETARIAT 022-4233185-|- 022-4203565 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
458 1829 RSIA. LIMIJATI JL. LAKS L RE MARTADINATA 33-39 IBU MEIKE Marketing 0224207770| 0224-4260956 Y Y Y ACTIVE ALL COVERAGE [email protected]
459 1170 RS. SANTO YUSUP JL. CIKUTRA 7 BANDUNGIBU DIAH/ BPK
HENDROMARKETING
022-7208172,022-7217097,
022-7217103, 022-
7231721|
022-7202419 Y N Y ACTIVE ALL [email protected]
d
460 2166 APOTEK FARMARIN BANDUNGJL. KH AHMAD DAHLAN (JL. BANTENG)
NO 62, BUAH BATU
DRA. SRI
WULANDARI, APTAPOTEKER 022-7300660| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
461 2167APOTEK FARMARIN BANDUNG 2
TUBIS
JL. TUBAGUS ISMAIL NO.79 RT/RW
004/012 KEL.SEKELOA KEC. COBLONG
BANDUNG
ARI PRIHANTINI,
S.SI, APTAPOTEKER 022-2500387| 022-2517116 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
462 0044 RSIA. HERMINA PASTEURJL. DR. DJUNDJUNAN, NO.107,
PASTEURIBU ANI / BP TANTO
MARKETING
KABAG022-6072525| 022-6037815 Y Y Y ACTIVE ALL COVERAGE
marketingpasteur@herminahospi
talgroup.com
463 1568 KLINIK UTAMA MONALISA JL. MOCH. RAMDHAN NO.32 IBU TINA MARKETING 022-5211311| 022-5200162 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
monalisa.medical.centre@gmail.
com
464 1087 RS.BUNGSU JL. VETERAN, NO.6 IBU ELLY MARKETING 022-4231550-|- 022-4231582 Y Y Y ACTIVE ALL COVERAGE [email protected]
JAWA BARAT
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 17 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI465 0144 RS. IMMANUEL BANDUNG JL. KOPPO, NO.161 IBU.NYOMAN MARKETING
022-
5201051/5201672/5224216
022-5224216|022-5224216
022-5224219 Y Y Y ACTIVE ALL [email protected];
466 1687 RS. IMC
JL. RAYA CIAMREME NO 170-173
NGAMPRAH, PADALARANG, BANDUNG
BARAT
DR. ARI / BAPAK
ASEPMARKETING 022-6620923/6620965| 022 - 6620964 Y Y Y ACTIVE ALL COVERAGE
467 1265APOTEK KIMIA FARMA SULAJANA (KF
51)JL. SULAJANA NO. 24
IBU YETHI/DRS.
CHANDRA
HARIBOWO,APT
KOORDINATOR 022-91512935| 022-4261088 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
468 1515 RS.MELINDA JL. PAJAJARAN, NO.46 IBU RAISYA / INDAH MARKETING
022-
4222788,4222388,4209088,
4266700|
022-4215700 Y Y Y ACTIVE ALL [email protected];
469 3366 SANTOSA HOSPITAL BANDUNG KOPOJL. K.H. WAHID HASYIM (KOPO),
NO.461-463 BANDUNG
IBU DISTIA/DR.
ANGGIE
ARIANDHITA
Marketing 022-54280333|
022-
5402242/5428036
5
Y Y Y ACTIVE ALL COVERAGEdistia.puspitasari@santosa-
hospital.com;
470 2734 RSU. PINDADJL. JEND. GATOT SUBROTO NO.517
(PAPANGGUNAN) BANDUNG 40285ALLIN PERAMA MARKETING 022-7322877/7309807| 022-7322468 Y Y Y ACTIVE ALL COVERAGE
471 2730 KLINIK & APOTIK K-24 JL. LASWI NO.1A,BANDUNGASTI YUNIA
(085861868000)(022) 7821700/7215992| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
472 2704 KLINIK & APOTEK KF 43 JL. BUAH BATU, BANDUNGDRS. MUHAMMAD
HILMI,APT- 022 7305019| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
473 2705 KLINIK & APOTEK KF 320 JL. CINUNUK NO.192, BANDUNG TATI SUHARTATI - 022 7801875| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
474 2719 KLINIK JAYA SENTOSA JL. SUNDA NO.75, BANDUNG
CHARLES (022-
70988880) / LINE
ROSTATI (022-
9264161
- 022 426 4258| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
475 2720KLINIK JAYA ABADI ( GROUP JAYA
SENTOSA)JL. BUAHBATU NO.245 , BANDUNG
CHARLES (022-
70988880) / LINE
ROSTATI (022-
9264161
- (022) 730 4273| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
476 0303 RS. ADVENT BANDUNG JL. CIHAMPELAS, NO.161 BPK. YUDHI MARKETING 022 -2034386-9/2034388|022-
2043167/2041109Y Y Y ACTIVE ALL COVERAGE [email protected];
477 1578 RS. HERMINA ARCAMANIKJL. AH.NASUTION, KM.7, NO.50,
ARCAMANIK BANDUNGRINI HANDAYANI MARKETING 022-87242525| 022-7271771 Y Y Y ACTIVE ALL COVERAGE
arcamanik@herminahospitalgrou
p.com
478 2625 KLINIK & APOTEK KF 12 JL. IR H JUANDA NO1 BANDUNG BPK MULYADIPENANGGUNG
JAWAB022 4205421| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
479 2626 KLINIK & APOTEK KF 14 JL. CIAMPELAS 7, BANDUNG ONO DARS. ONOPENANGGUNG
JAWAD022-4201596| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
480 2622 KLINIK UTAMA AL-ISLAMJL. AWIBITUNG NO.29 CICADAS
BANDUNG 40121
M. SAEFULLOH
HASAN- (022) 7208284| (022) 7276149 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
481 3588 KIMIA FARMA SINDANGLAYA JL. AH.NASUTION NO.126 B LEA OKTAVIANI Apoteker 0227278664| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
482 3589 KIMIA FARMA 319 METRO JL. VENUS RAYA NO 27 - - 0227564623| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
483 3591 APOTEK KIMIA FARMA 381 KOPO JL. KOPO CIRANGRANG NO.638 - - 0225436596| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
484 3592 KIMIA FARMA SETIABUDI JL. DR.SETIABUDHI NO 36, BANDUNG HANI NOVIANI - 0222038048| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
BANJARBEKASI
485 1517 RSU. DR. ADAM TALIB JL. TEUKU UMAR, NO.25, CIBITUNG IBU. SULIS Marketing 021-88332305/06| 021-88332308 Y Y Y ACTIVE ALL COVERAGE [email protected]
486 1277 RB & KLINIK GUCI MEDIKA JL. PRAMUKA NO.79 RAWA LUMBU BP ARIF MARKETING 021-82433158| 021-8221921 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
487 1293 KLINIK YAKESTI BEKASIJL. RAYA NAROGONG KM.7 NO.45
BOJONG MENTENGBPK. ARIEF MARKETING -021 8253516| - N Y Y ACTIVE ALL COVERAGE -
488 1296 RSB. TAMAN HARAPAN BARUJL. TAMAN HARAPAN BARU RAYA, BLOK
R-I,NO.20,PEJUANG MEDAN SATRIAIBU MERRY MARKETING 021-88871202| 021- 88871203 Y Y Y ACTIVE ALL COVERAGE [email protected]
489 1304 RSIA. PUSPA HUSADAJL. RAYA PONDOK TIMUR KM. 1, NO 27
JATIMULYA TAMBUN SELATAN-BEKASIBPK. EDI SUTIKNO MARKETING 021-82618978/82618979| 021-82618977 Y Y Y ACTIVE ALL COVERAGE [email protected]
490 1333 RSU. KARTIKA HUSADA JATIASIHJL. SWANTARA NO 72 JATI ASIH,
BEKASIIBU EMIL - 021-82435585-82435587| 021-82435586 Y Y Y ACTIVE ALL COVERAGE [email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 18 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI491 1530 KLINIK SIERRA MITRA
JL. KH. M.TABRANI BLOK I NO. 1 A-1B,
MARGAMULIA, BEKASI UTARABPK. KRISNA MARKETING 021-70266392/8868129| 021-8868129 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
492 1541 RS. PERMATA BEKASIJL. LEGENDA RAYA, NO. 9, MUSTIKA
JAYA
DRG.RIMA/BPK.
ASEPMARKETING 021-8251919/8254748| 021-82609705 Y Y Y ACTIVE ALL COVERAGE [email protected]
493 1559 RB & KLINIK TIARA BUNDAJL. RAYA PERJUANGAN NO. 1,
PERTIGAAN TELUK PUCUNGDR.LINDA KOORDINATOR 021-89131010| 021-89131010 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
-
494 1122 RS. JATI SAMPURNA JL. STUDIO ANTV KRANGGAN DRG. IKHWAN PANE MARKETING 021-8451457| 021- 8455712 Y Y Y ACTIVE ALL COVERAGE [email protected]
495 1576RS TAMAN HARAPAN BARU (d/h
praktek bersama dokter)
JL KALIABANG TENGAH RT 04/23 KEL.
PEJUANG KEC. MEDAN SATRIAIBU YESSI FRISELLA MARKETING 021-88981055| 021-88981055 Y Y Y ACTIVE ALL COVERAGE
496 1038 KLINIK HARAPAN SEHAT IIIPERUMAHAN VILLA MUTIARA JAYA,
BLOK MB 16/7, CIBITUNGDR.ERNA KOORDINATOR 021- 68295994/88393875-|- - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
497 0947 RS. APRILIA MEDIKAJL. RAYA SETU NO.99 DESA LUBANG
BUAYA, KEC SETU BEKASIBPK. AFNAN RIFAI MARKETING
021 - 82611565021-
5901312|021-5901312021 - 82611565 Y Y Y ACTIVE ALL COVERAGE [email protected]
498 0949BP DR. SANDER B(D/H KLINIK
HOSANA MEDICA CIBITUNG)JL. TEUKU UMAR NO.19 CIBITUNG DR PETER KOORDINATOR 021-8833 8414-|- 021-8833 8413 N Y Y ACTIVE ALL COVERAGE
499 0950KLINIK HOSANA MEDICA MANGUN
JAYA (HOSANA MEDIKA IV
JL. MANGUN JAYA INDAH II BLOK G10
NO. 3 TAMBUN BEKASI 17510DR HENY KOORDINATOR (021) 8832-0349-|- (021) 8832-0349 N Y Y ACTIVE ALL COVERAGE
500 1051RB & KLINIK ANGELIKA (RB.
DEBORAH)
PERUMAHAN PONDOK TANAH MAS JL.
BOSIH RAYA BLOK E15 NO.12-13
CIBITUNG
BIDAH DEBORAH PEMILIK 021-88330750-|- - N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
-
501 1053 RS. ST. ELISABETH - BEKASIJL. RAYA NAROGONG NO.202 KEMANG
PRATAMA
BPK. ANTON/IBU
YUNIMARKETING/KEU
021-
82430101/82432949/82400
186/8229767021-
82432082|021-82432082
021-82432083 Y Y Y ACTIVE ALL COVERAGE [email protected]
502 0622 RSU. MITRA MEDIKA
JL. DESA JATIWANGI-
CIKEDOKAN/SEBELAH SELATAN
KAWASAN MM 2100 KP KAMURANG RT
1/1 CIKEDOKAN, CIKARANG BARAT
BP.H. MINDA S PEMILIK021-8998
3741/71691709/98213879|021-89983575 Y Y Y ACTIVE ALL COVERAGE [email protected]
503 0588 KLINIK MELVIANAJL. SAPARUA RAYA NO.239 - 240
PERUMNAS III BEKASIIBU YULINDA Marketing 021-8807610 / 88354744| 021-88341291 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
504 0036 RS. SENTOSAJL. PAHLAWAN, NO.60 DUREN JAYA,
BEKASI TIMURIBU SARI MARKETING 021-880 6140| 021-881 4950 Y Y Y ACTIVE ALL COVERAGE [email protected]
505 0324 RS. GRAHA JUANDA JL. IR. H. JUANDA, NO.326 IBU PUJI MARKETING021- 8811832,8821004021-
8811832|021- 8811832021 - 88346880 Y Y Y ACTIVE ALL COVERAGE [email protected]
506 1140 RS. RAWA LUMBUJL. DASA DARMA, NO.20-23, RAWA
LUMBUBAPAK AGUS Marketing 021-82422511| 021-82432958 Y Y Y ACTIVE ALL COVERAGE [email protected]
507 0974 KLINIK MITRA MEDIKA JL. AGUS SALIM NO. 173 IBU SETYO KOORDINATOR021-8802886/ 021-8802886-
|-021-8802457 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
508 0982 RS. BUDI LESTARIJL. KH.NOER ALIE, NO.2 DEPAN
PERUMNAS II, KALIMALANGIBU JULIA MARKETING
021-8842336/8893486021-
8893486|021-8893486021-8893487 Y Y Y ACTIVE ALL COVERAGE
o.id
509 0987RB & KLINIK HARAPAN SEHAT
CIBITUNGJL. TEUKU UMAR NO.33 CIBITUNG IBU RIA MARKETING 021-88336674-|- 021-8901126 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
510 0988 RS. PERMATA BUNDA BEKASIPERUM GRAMAPURI TAMANSARI C1/8-
10 CIBITUNG
BPK ROKIB/BPK
HARIRIKOORDINATOR 021-88328001/88392537-|- 88328002 Y Y Y ACTIVE ALL COVERAGE
marketingrspb@permata-
bunda.com/marketing_rspb@ya
h
511 1120 KLINIK PURI NUSAPHALAJL. CITRA INDAH A/14 PERUM PURI
NUSAPALA JATI ASIHBPK.TEGUH MARKETING 021-82440368/7| 021-82440368 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
512 1123 RS. CITRA HARAPAN
JL. RAYA HARAPAN INDAH
KAW.SENTRA NIAGA NO.3-5 MEDAN
SATRIA
IBU DEWI MARKETING
021-
88870606/88870909/88865
792-93|
021-88975555 Y Y Y ACTIVE ALL COVERAGE [email protected]
513 1206 KLINIK SADRINA MEDIKA II
JL. PERUM BEKASI TIMUR REGENSI
BLOK.H2 NO.12, KEL.CIMUNING,
BEKASI TIMUR
IBU ANI Koordinator021-82612828 /
081212103703|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
514 1207 KLINIK DIPONEGORO JL. DIPONEGORO NO.26 TAMBUN IBU VIVI KOORDINATOR 021 - 8817062| 021-88346743 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
515 1216 RS. JUWITA JL. M. HASIBUAN NO.78 - BEKASI Ibu Nia MARKETING 021 -8829590/1| 021-8829592 Y Y Y ACTIVE ALL COVERAGE [email protected]
516 1136 KLINIK PERMATA BUNDA BEKASIJL. BOSIH RAYA RUKO KARTIKA
WANASARI BLOK.C1/4 CIBITUNGBAPAK ROKIB Koordinator
021- 88373158 / 021-
88328001/ 88392537|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
517 1090 RS. PERMATA CIBUBURJL. ALTERNATIF CIBUBUR - CILEUNGSI
NO.6A BEKASI
IBU
MARLINA/RIYANIMARKETING, CS 021-8458806-|- 021-84592146 Y Y Y ACTIVE ALL COVERAGE
m; rianicleopatra@yah
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 19 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI518 1259 KLINIK WIJAYA KESUMA
JL. NAROGONG SAKTI RAYA BLOK A 20
NO.1IBU FARISYAH KOORDINATOR 021 - 8210779| 021 - 8226455 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
519 0010 RS. MITRA KELUARGA BEKASI BARAT JL. JEND. A.YANI, BEKASI BARAT IBU TITI MARKETING 021-8853333|021-
8842550/8855000Y Y Y ACTIVE ALL COVERAGE
m
520 0032 RB. BUNDA AUNI VILLA NUSA INDAH, BLOK D5, NO.19 BPK.MUKLAS KEUANGAN
021-
82402286/82420366/82403
873|
021-82410136 N Y Y ACTIVE ALL COVERAGE [email protected]
521 0147RS KARYA MEDIKA BANTAR
GEBANG(d/h KARYA MEDIKA IV)
JL. NAROGONG RAYA, KM.11, BANTAR
GEBANGBPK. ALLOSIUS
PELAYANAN
PASIEN021-8254629|021-8254630 021-8254629 Y Y Y ACTIVE ALL COVERAGE
522 0151KLINIK MULYA MEDIKA (APOTIK
MURNI)
JL. RAYA JATI MULYA, NO.1, BEKASI
TIMURBPK. RUNTUNG MARKETING 021-8203272| 021-8203272 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
523 0409 KLINIK DHARMA MEDIKA JL. PEMUDA, NO.33, KRANJI IBU BETTY KEUANGAN 021-8855173,8866711| 021-8866711 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
524 0185 RS. BHAKTI KARTINI JL. KARTINI, NO.11IBU HILDA/ BPK
FIRMANMARKETING 021-8801954/88348492| 021-8824228 Y Y Y ACTIVE ALL COVERAGE
525 0767 KLINIK MHT BEKASIJL. H.M JOYO MARTONO NO.31B
BEKASI TIMUR
DR FRISKA
GULTOM/IBU DJESKOORDINATOR 021-8814262| 021-8814262 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
526 0620 RS. KARYA MEDIKA II (D/H RSIA. )JL. SULTAN HASANUDIN NO.63
TAMBUNIBU. DEBBY / MERY MARKETING
021-883 24366;
70934766021-
88361980|021-88361980
021-88327514 Y Y Y ACTIVE ALL COVERAGEmarketing-
527 0766 RS. ANANDA BEKASIJL. SULTAN AGUNG NO.17, MEDAN
SATRIA BEKASIBPK JOKO/BRAM MARKETING 021-8854338| 021- 88950141 Y Y Y ACTIVE ALL COVERAGE
528 0410 RS. BELLA JL. IR. JUANDA, NO.141 IBU AMEL GRACE MARKETING
021-880 1775/
880177/8819377021-
880177|021- 880177
02188342438/883
52506Y Y Y ACTIVE ALL COVERAGE [email protected]
529 0384 RS. MEKAR SARI JL. MEKAR SARI, NO.1 DRG. AMI MARKETING021-8802641,8813787021-
8813787|021-8813787
021-
8810055/8835090
8
Y Y Y ACTIVE ALL COVERAGE [email protected]
530 0250 KLINIK KARYA MEDIKA I JL. IR H JUANDA NO.38 C BPK HERMAN KOORDINATOR021-8801293021-
8800381|021-8800381021-8816137 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
531 0188KLINIK FAJAR MEDIKA ( GROUP
KARYA MEDIKA )
RUKO KAWASAN INDUSTRI MM2100,
CIBITUNGIBU INA MARKETING 021-8981162| 021-8981162 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
532 0887 KLINIK MULYA MEDIKA IIJL. PERUMAHAN GRAMA PURI, BLOK
D1, NO.5, CIBITUNGBPK. HAKIM KOORDINATOR 021-8836248| 021-88362481 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
533 0715 KLINIK MUTIARA I (CITRA HUSADA I)PERUM METLAND JL. KALIMAYA 6 BLOK
L2 / 1 BEKASI
BPK. KEMAL / BPK.
RONNY/KEUANGAN 021-29487893| 021-88337919 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
534 0294KLINIK KARYA MEDIKA III (APOTIK
MEKAR ASRI)
JL. PERJUANGAN, NO.30C, TELUK
BUYUNGIBU EUIS KOORDINATOR 021-8851152| 021-8851152 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
535 0819 RB & KLINIK PERMATA BUNDA SETUPERUM GRAHA MUSTIKA MEDIA, BLOK
A5, NO.15, SETUIBU TIA ADM 82611729 / 88328001| 82611729 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
536 0847 RS. ANNAJL. PEKAYON RAYA NO.36, BEKASI
SELATANIBU MAMI MARKETING 021-82432211| 021-82419079 Y Y Y ACTIVE ALL COVERAGE [email protected]
537 0873 APOTIK & KLINIK LEGENDA SEHATJL. ZAMRUD UTARA BLOK U16 NO.100
KOTA LEGENDABPK.BUDI JULIANTO KOORDINATOR 021-82600148| 021-82606179 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
538 2539 MITRASANA PONDOK TIMUR
PONDOK TIMUR INDAH BLOK G NO 1
PONDOK TIMURKEL JATIMULYA KEC
TAMBUN SELATAN KAB BEKASI
- - 36822510 / 08891259024| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
539 2461KLINIK 24 JAM & RB. PERMATA
BUNDA CIBITUNG
JL. RAYA WANAJAYA - CIBITUNG,
BEKASIIBU ZENDRI - 021 - 88322064, 88323062| - N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
540 2545 MITRASANA TITIAN INDAH
JL. PERUM TITIAN INDAH BLOK I NO 9
RT 07 RW 10 KEL. KALIBARU KEC
MEDAN SATRIA KOTA BEKASI
- - 021-94178815| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
541 1816 RS. HARAPAN MULIAJL. RAYA CIBARUSAH NO. 5 KB. KOPI,
CIBARUSAH JAYA KAB. BEKASI
HENDRO L
PRASETYO / LINDAMARKETING 021-89952340| 021-89952460 Y Y Y ACTIVE ALL COVERAGE [email protected]
542 1830 RB & KLINIK AMIRA CIKARANGJL. RAYA BY PASS LEMAH ABANG,
CIKARANG TIMURDR. DEDY - 021-8914 2719| 021-89142719 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
543 1937 APOTIK FARMARIN VII BEKASI
JL. GURAME RAYA PERTOKOAN KAV.29
PERUMNAS KAV.29 PERUMNAS II KEL,
KAYU RINGIN RAYA KEC BEKASI
SELATAN.
HIKMAH APRILIANI - 02188968419| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 20 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI544 1924 KLINIK MANDIRI
PERUM VILLA MUTIARA CIKARANG
BLOK R 26-27 CIKARANG SELATAN
IBU.IIN IRA
KARTIKAPEMILIK 021-897 4883| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
545 2057 KLINIK BATARA SATU MEDIKAJL. KH. NOER ALI NO. 10 KP. IRIAN RT.
03/04 TELUK PUCUNG, BEKASI UTARAASEP KUSTARA - 021-89133229| 021-82589090 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
546 2091 KLINIK SITI ZAHROHPERUMAHAN GRAND RESIDENT RR 100
SETU - BEKASIBPK ERI PEMILIK 021-8261.8362| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
547 2036 RB & KLINIK DR IQBAL TAUFAN
VILA MUTIARA CIKARANG 2 BLOK B1
NO. 27, DESA SUKASEJATI CIKARANG
SELATAN, BEKASI
IBU NANIK KOORDINATOR 021-89902361| 021-89902361 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
548 1971 RB. WIJAYANTIJL. PERUM GRIYA BEKASI PERMAI BLOK
H6 NO 17, TELAJUNG-CIKARANG BARATIBU MOMO PEMILIK 021-29371856/97958619| 021-82602243 N Y Y ACTIVE ALL COVERAGE -
549 1951 KLINIK & APOTEK KF 387JL. JATIWARINGIN NO 5 PONDOK GEDE
BEKASISHINTA YULIZRA - 021-8461980| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
550 1965 KLINIK KU JL. DR. RATNA JATI ASIH BEKASIDR. SARI
RAHADJENG- 021-84901303| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
551 1584 KLINIK RIBU MEDIKAJL. RAWA JULANG DESA MEKARWANGI
KEC. CIKARANG BARAT, BEKASI
IBU ROSTARIA
BANGUNKOORDINATOR 021-91303916/89983577| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
552 0063 RS. MULTAZAM MEDIKAJL. PERUMAHAN JATIMULYA NO.1
TAMBUN SELATAN, BEKASI 17510IBU IRMA MARKETING
021-8215101/8215102021-
8215102|021-8215102021-82416678 Y Y Y ACTIVE ALL COVERAGE [email protected]
553 1553 RS. HERMINA GRAND WISATAJL. FESTIVAL BOULEVARD BLOK JA NO.
I, GRAND WISATA,BPK.SUNGKONO MARKETING 021-8265 1212| 021-825 2963 Y Y Y ACTIVE ALL COVERAGE
grandwisata@herminahospitalgr
oup.com
554 0016 RS. KARYA MEDIKA CIBITUNGJL. RAYA IMAM BONJOL, NO.9B,
CIKARANG BARAT, CIBITUNG
IBU
TITIN/FERYANA/IND
AH
MARKETING021-8900190-1 & 8903003-
4|021-89107753 Y Y Y ACTIVE ALL COVERAGE [email protected]
555 1588RB. ASYIFA HUSADA MEDICAL
CENTER
PERUM. BEKASI REGENCY I BLOK K I
NO. 1, CIBITUNGERWAN JAUHARY MARKETING 021-88333535| 021-88332152 Y Y Y ACTIVE ALL COVERAGE [email protected]
556 1595 KLINIK VNV MEDIESTETIKOMPLEK PEMDA BLOK C JATI ASIH
BEKASIBP SOFYAN Marketing 021-82435767| 021-82435767 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
557 1334 RS. ANNA MEDIKAJL. RAYA PERJUANGAN NO 45,
HARAPAN BARU, BEKASI UTARA
IBU ELA
KUSMIATI/BPK.
ALIM
MARKETING 021 - 88882211| 021 - 88973042 Y Y Y ACTIVE ALL COVERAGE [email protected]
558 1350 RS. MITRA KELUARGA CIBUBUR JL. ALTERNATIF TRANSYOGI, CIBUBUR IBU RINA MARKETING 021-84311771/84311777| 021-84311661 Y Y Y ACTIVE ALL [email protected]
m
559 1586 RSIA. SRITINA JL. IMAM BONJOL NO.80A BEKASI IBU INDAH MARKETING 021-8900579-89106317| 021-89106633 Y Y Y ACTIVE ALL COVERAGE [email protected]
560 1640 RS. JATI RAHAYUJL. RAYA HANKAM NO 17 PONDOK
MELATI BEKASIIBU SHINTA MARKETING
021-
8462566,8462565,8497257
8|
021-84992723 Y Y Y ACTIVE ALL [email protected];
561 1769 KLINIK SATELIT GSM BEKASIBEKASI SQUARE NO 65-66 JL. AHMAD
YANI PEKAYON JAYA BEKASI SELATANBPK AGUNG - 021-82425408| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
562 1771 RS. KARTIKA HUSADA SETUJL. BURANGKENG RT 01/06 DESA
BURANGKENG SETU BEKASI
IBU ANDRI
ICHSANTIMARKETING 021-82610003/4| 021- 82610005 Y Y Y ACTIVE ALL COVERAGE [email protected]
563 1807 RS. TIARA BEKASIJL. RAYA BABELAN NO. 63 KEL.
KEBALEN KEC. BABELAN KAB. BEKASIIBU LITA Marketing 021-89131111| 021-89132039 Y Y Y ACTIVE ALL COVERAGE
564 1486RS. AWAL BROS BEKASI (D/H RS.
GLOBAL AWAL BROS )
JL. KH.NOER ALI KAV.17-18
KALIMALANGBPK YADI/IBU MIMI MARKETING 021-8868888/88855333|
02188855222/888
55210Y Y Y ACTIVE ALL COVERAGE [email protected]
565 1261 RS. HOSANA MEDICA BEKASI JL. PRAMUKA NO.12 RAWA LUMBU BP YOSEP DIREKTUR 021-8221570/73|021-
8224604/8221574Y Y Y ACTIVE ALL COVERAGE
anamedicabekasi1@gmail
566 1417 RSIA. RINOVA INTAN JL. RAYA SEROJA NO.101 BPK.LUHUT KOORDINATOR 021-8849401| 021-8848739 Y Y Y ACTIVE ALL COVERAGE -
567 1203 KLINIK SEHAT SEJAHTERA IJL. RAYA NUSANTARA NO.2 PERUMNAS
III BEKASI TIMUR
IBU.JANAH/HAYATI
WIDIODOKoordinator 021-88349427| 88349427 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
568 1204 KLINIK SEHAT SEJAHTERA II PERUM REGENSI - BEKASI TIMURIBU.PUJI/HAYATI
WIDODOKoordinator 021-88367194| 88349427 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
569 1062 RS. CIBITUNG MEDIKAJL. RAYA H.BOSIH NO.117
DS.WANASARI,CIBITUNG-BEKASI
RUSTOMY FADILLAH
/ ENNIKE
MARYATININGRUM
Marketing 021-88323444/88393181-|-02188323449/883
72866Y Y Y ACTIVE ALL COVERAGE [email protected]
570 1989RSIA. KARUNIA KASIH (KARUNIA
BUNDA)
JL. RAYA JATI WARINGIN NO. 133
PONDOK GEDE KOTA BEKASIIBU GRACE Marketing 021-8461970| 021- 8460991 Y Y Y ACTIVE ALL COVERAGE
m
571 3367 KLINIK CENTRAL MEDIKA2
JL. KH. FUDHOLI (KEBON KPI) DESA
KARANG ASIH, KEC. CIKARANG UTARA
KAB. BEKASI
DR. LIA -- 021-89100879| 021-89100877 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
572 0178 RS. HERMINA BEKASI JL. KEMAKMURAN, NO.39, MARGAJAYADR.CHEYRA/IBU.CH
RISTINEMARKETING 021-8842121/30| 021- 88952275 Y Y Y ACTIVE ALL COVERAGE
m
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 21 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI573 3382 KHARISMA MEDICAL CENTER JL. CAMAN RAYA NO.54 BEKASI IBU TIARA MARKETING 021-84991671| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
marketing@kharismamedicalcent
er.co.id
574 2528 MITRASANA ALAMANDA REGENCY
"JL. KAMPUNG RAWA KALONG RT 01/
RW 03 KARANG SATRIA BLOK N 01 NO
43 TAMBUN UTARA, BEKASI
ELI NURHAYATI - 70874627/ 08891258883| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
575 2534 MITRASANA KRANJIJL. FAJAR NIAGA D1 NO 73 KEL JAKA
SAMPURNA KEC BEKASI BARATIBU DEVI koordinator 88951275| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
576 2613 KLINIK & APOTIK MAHADINA MEDIKA JL. KH. BOSIH NO.9 CIBITUNG EEN - -| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHARumar.bakrun.bakrun85@gmail
577 2508 MITRASANA TAMAN HARAPAN BARU
JL. TAMAN HARAPAN BARU BLOK E7
NO 9, PEJUANG, MEDAN SATRIA,
BEKASI BARAT
- - 88870793 / 08891259038| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
578 2802 KLINIK PERTAMEDIKA BEKASI
RUKO KALIMALANG SQUARE BLOK J
NO. 17, JL. KALIMALANG RAYA -
BEKASI BARAT
HENDRI
(081806762901)- 021-88962946| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
579 2803KLINIK PERTAMEDIKA JATIWARINGIN
ASRI
JL. SANGATTA NO. 1 JATIWARINGIN
PONDOK GEDE 17411
SRI ENDRA
(081317520046)- 021-84990644| 021-84970944 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
580 2402KLINIK & RB CAHAYA MEDIKA (Group
HARAPAN SEHAT CI)
Jl. Rawa Julang RT. 02/01, Desa Ganda
Mekar Kec. Cikrang Barat ¿ BekasiDR. ERNA - (021) 8998 4009| - N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
-
581 2689 KLINIK & APOTEK KF 367 JL. JATIMEKAR NO. 33 JATIASIHNUR FADILLAH,S
FARM., APT.021 8473403| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
582 0161 RS. MITRA KELUARGA BEKASI TIMURJL. PENGASINAN RAWA SEMUT
MARGAHAYU, BEKASI TIMURIBU LINDA/ HARTI MARKETING 021-8817777/89999222|
8820707/8999928
6Y Y Y ACTIVE ALL COVERAGE
om
583 0891 RS. HERMINA GALAXYJL. GARDENIA RAYA SELATAN BLOK
BA1 NO.11BPK.DEFNI MANSUR MARKETING 021-8222525/82417777| 021-82414087 Y Y Y ACTIVE ALL COVERAGE
m
584 2433 KLINIK TAMAN FIRDAUS MEDIKAPERUM TAMAN FIRDAUS RESIDENCE
BLOK A 06 NO.17 CIBARUSA BEKASIBPK ERIK/ BP RICO - 021 - 89950047| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
585 2611 KLINIK AMELIA
VILA MUTIARA GADING 2 KOMPLEK
RUKO ROXY BLOK DD.10 NO.1 KARANG
SATRIA BEKASI
DR. IDA ROHAYANI - -| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
586 2560 MITRASANA MOCHTAR TABRANI
JL. KH MUCHTAR TABRANI RT 003 RW
03 KEL. PERWIRA KEC. BEKASI UTARA
KOTA BEKASI
TIKA - 36822504/ 08891259008| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
587 2594MITRASANA BUMI CIKARANG
MAKMUR
BUMI CIKARANG MAKMUR BLOK F 10
NO. 6 KEL. SUKADAMI, KEC. CIKARANG
SELATAN, KAB. BEKASI
IBU RATMI Koordinator021-36164232/ 021-
34618046|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
588 2512 MITRASANA KAMPUNG CEREWED
RUKO LIBERS. A GARDEN NO. 23 JL.
KARANG SATRIA(SEBELAH PERUM
KAMPUNG CEREWED), DUREN JAYA
BEKASI TIMUR
- - 88343753| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
589 2514 MITRASANA PESONA KHAYANGAN
RUKO PESONA KHAYANGAN BLOK B
NO.6 , JL. M. YUSUF, KEL. MEKARJAYA,
KEC. SUKMAJAYA
IBU ELVANA (STORE
MANAGER)- 77822980| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
590 2515 MITRASANA KALIABANG
"RUKO FITRA JAYA, JL. KALIABANG RT
01/06 NO. 7 KEL PERWIRA KEC BEKASI
UTARA
INA MASTUHA - 021-88974206| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
591 2518MITRASANA MUTIARA GADING
TIMUR
RUKO MUTIARA GADING TIMUR 2 BLOK
R 02-23 KELURAHAN MUSTIKA JAYA
KECAMATAN BANTAR GEBANG BEKASI
NURHASANAH - 085100771573| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
592 2520 MITRASANA UJUNG HARAPAN
"KAMPUNG UJUNG HARAPAN RT 02/ RW
15 KEL. BAHAGIA KEC. BABELAN KAB.
BEKASI
IVANA - 021-29258727/ 70874627| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
593 2521 MITRASANA BUMI SANI PERMAI
"JL. BUMI SANI PERMAI RT 02 RW 011
KAMPUNG BULU KEL SETUIA MEKAR
KEC TAMBUN SELATAN BEKASI
TINI - 71347468| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
594 2523 MITRASANA HARAPAN BARU 2"PERUM HARAPAN BARU II D8-02 RT 03
RW 02 KOTA BARU BEKASI BARATAFAL MASANI - 88950943| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
595 2525 MITRASANA SAKURA REGENCY
"JL. WIBAWA MUKTI 2 KOMP. SAKURA
REGENCY BLOK KM 8 ¿ 12 JATIASIH
BEKASI
MIRA - 021-82441692| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
596 2527 MITRASANA KOTA SERANG BARU
"JL. PERUM KOTA SERANG BARU BLOK
A/47 NO 5 KEL SUKARAGAM, KEC
SERANG BARU KAB BEKASI
- - 36502354| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 22 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI597 2531 MITRASANA GRAND WISATA
RUKO CELEBRATION BOULEVARD BLOK
AA9 NO.12 PERUMAHAN GRAND
WISATA KEL. LAMBANG SARI KEC.
TAMBUN BEKASI
- - 71209133 / 08891258904| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
598 2533 MITRASANA PEKAYON JAYA
RUKO PENINSULA JL. PULO RIBUNG RT
01 NO. 1D KEL. PEKAYON JAYA KEC.
BEKASI SELATAN BEKASI SELATAN
RANI - 82429641| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
599 2535MITRASANA PEJUANG HARAPAN
BARU
JL. PEJUANG 04 BLOK B/ 234 RT 13 RW
11 PEJUANG MEDAN SATRIASUSI - 021-70813640| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
600 2509 MITRASANA PONDOK UNGU PERMAI
PONDOK UNGU PERMAI AC 1 NO 20A &
20B RT 003 RW 009, BAHAGIA,
BABELAN - BEKASI
INDRI RAHMAWATI - 021-88882300| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
601 2511 MITRASANA DUKUH ZAMRUDJL. ZAMRUD UTARA RUKO BLOK S.1
NO. 18 KOTA LEGENDA,BEKASI TIMUR- - 08891258897/ 82602911| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
602 2513 MITRASANA MEGA REGENCY 2
"JL. PERUM MEGA REGENCY BLOK D3
NO 5 KEL SUKARAGAM KEC SERANG
BARU KAB BEKASI
- - 36771573/ 08891259006| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
603 0735 RS. KARTIKA HUSADA TAMBUN
JL. MANGUN JAYA RAYA KP.RUKEM
RT.003/013, DESA MANGUN JAYA,
TAMBUN - BEKASI
SRI
WARDININGSIH/FIT
RI/ANJAR
MARKETING
021-88338346,
88327281021-9172736|021-
9172736
021-88322529 Y Y Y ACTIVE ALL COVERAGE [email protected]
604 0843 KLINIK DHARMA BHAKTI
JL. RAYA BOSIH BLOK A4 NO.23
PONDOK TANAH MAS, CIBITUNG -
BEKASI
BPK SUDIARTO HUMAS 021-8831441-|-021-
8831441/8830246N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
605 1558 KLINIK ASYIFA HUSADAPERUM. VILLA MUTIARA JAYA BLOK N.
78 /11-12, WANAJAYA, CIBITUNGERWAN JAUHARY KOORDINATOR 021-88338235| 021-88338235 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
BOGOR
606 3000 RSUD. KOTA BOGORJL. DR. SUMERU NO. 120 MENTENG,
BOGOR BARAT 16111
IBU RINA/BPK YANI/
MIA- 0251-8312292| 0251-8371001 Y Y Y ACTIVE ALL COVERAGE
607 2517 MITRASANA VILLA NUSA INDAH
PERUM VILLA NUSA INDAH BLOK F2
NO. 15 DESA BOJONG KULUR KEC.
GUNUNG PUTRI KAB. BOGOR
- - 82429508| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
608 2955 RS. PERMATA JONGGOL
JL. RAYA JONGGOL NO.1 A RT.008
RW.03, SUKAMANAH, JONGGOL,
BOGOR
IBU ARUM MARKETING 021-8993 1222| 021- 8993 1836 Y Y Y ACTIVE ALL [email protected];
609 3990 RSIA. BUNDA SURYATNI
JL. KH. SOLEH ISKANDAR NO. 21,
CIBADAK, TANAH SAREAL, BOGOR
16161
Nuna Nur Mina MARKETING (0251) 754 3892| (0251) 754 3892 Y Y Y ACTIVE ALL COVERAGE [email protected]
610 2393 RSIA. UMMIJL. EMPANG II NO.2 BOGOR RT.004/002
BOGOR SELATANBAPAK DEDE MARKETING 0251-8341600| 0251-8341606 Y Y Y ACTIVE ALL COVERAGE [email protected]
611 3420 RS. MULIA PAJAJARAN JL. RAYA PAJAJARAN NO. 98, BOGORIBU EFI/ DR
RADIANTIDIREKTUR 0251-8379898| 0251-8378800 Y Y Y ACTIVE ALL COVERAGE
612 2979 LAB. KLINIK KIMIA FARMA BOGOR JL. IR. H. JUANDA NO. 30, BOGOR IBU YUNI KOORDINATOR 0251 - 8319030| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
613 3330 LAB. KIMIA FARMA 50 JL. MERDEKA NO. 24 BOGOR IBU UMI - 0251-271708| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
614 1235 KLINIK & APOTEK KF 7 BOGOR JL. IR. H JUANDA NO. 30 TUTI EKAWATI -0251-8363473 / 8319030
(Lab)|N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
615 2772 KLINIK SHIFA MEDIKAJL. BRANTA MULIA RT.002/07 KARANG
ASEM TIMUR, CITEUREUP - BOGOR
DR. RIANA
ROCHMAWATI
(081319980958)
- (021) 8760357| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
616 2759 RS. KARYA BHAKTI PRATIWIJL. RAYA DRAMAGA KM. 7, DRAMAGA,
BOGORBP NURWANDY MARKETING (0251) 8626868| (0251) 8626969 Y Y Y ACTIVE ALL COVERAGE
o.id
617 2718 KLINIK PELITA SEHAT CIOMASJL. RAYA TAMAN PAGELARAN BLOK C1
NO.5, PADASUKA, CIOMAS, BOGOR
DR. JUNAIDY
(08129922058)OWNER (0251) 7522167| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
618 2788 RSIA. ASSALAMJL. RAYA BOGOR KM 46, NANGGEWER
MEKAR, CIBINONG, BOGORIBU KHOLIS - (021) 8753724| - Y Y Y ACTIVE ALL COVERAGE [email protected]
619 2703 KIMIA FARMA 362 JL. MAYOR OKING 112 C, CIBINONG
ROSA TADIANTI
PUTRI, S.FARM.,
APT
- 021 87914400| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
620 0992 RS. BOGOR MEDICAL CENTER JL. PAJAJARAN INDAH V/97 BOGORDRH.SITTI NUR
ARAFAH, IBU LISNAMARKETING
0251-
8307900/8390435/8346002
/83797430251-
346002|0251-346002
0251-
8313987/8353419Y Y Y ACTIVE ALL COVERAGE
621 2809 KLINIK PERTAMEDIKA BOGORJL. PANDAWA BLOK A-1 NO 14-15
BANTAR JATI II BUMI INDAH PRASTA IIIN (081386613335) - 0251-8363994| 0251-8363993 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
622 3709 RS. VANIAJL. SILIWANGI NO.11 SUKASARI
BOGOR TIMURSKOLASTIKA SENDY MARKETING 0251-8380601/8380605| 0251-8380612 Y Y Y ACTIVE ALL COVERAGE [email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 23 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI623 2172 KLINIK BHAKTI RAHAYU LEUWILIANG
JL. RAYA GALUGA NO. 120
CIBUNGBULANG, BOGORBPK YUYU RAHAYU - 0251-8648201| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
624 2191 RS. MEDIKA DRAMAGAJL. RAYA DRAMAGA KM. 7.3
MARGAJAYA BOGORBP. YOGI MARKETING
0251- 8308900;
081319310610|0251- 862577 Y Y Y ACTIVE ALL COVERAGE [email protected]
625 2441 KLINIK NADYA MH THAMRIN
JL. KH ABDULLAH BIN NUH RT. 005/
RW. 01 KEL. SINDANG BARNAG, KEC.
BOGOR BARAT
DR. WENI
PUSPASARI- (0251) 8624629| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
626 2388 RS. PERTAMEDIKA SENTUL CITYJL. MH THAMRIN KAV 57 SENTUL CITY -
BOGOR 16810
dr. Bertie
riyestavaniMARKETING 021-29672990/29672977| - Y Y Y ACTIVE ALL COVERAGE
bertie.riyestavani@pertamedikas
entul.co.id
627 2456 RSIA. JULIANA JL. RAYA TAJUR NO 75A - BOGORIBU FITRI/ BPK
SURYAKERTAMarketing 0251 - 8339593| 0251-8339591 Y Y Y ACTIVE ALL COVERAGE [email protected]
628 2624 IZI CLINIC JL. ACHMAD ADNAWIJAYA NO.115YUZHI FADILAH
ARS. Y, S.FARMClinic Manager (0251) 8356621| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
willy-
629 0468 RS. PMI BOGOR JL. RAYA PAJAJARAN, NO.80 IBU CITRA/ YUDHA MARKETING 0251-8324080-|-0251-
8382936/8324709Y Y Y ACTIVE ALL COVERAGE
[email protected]/rspmi_k
630 1831 KLINIK PELITA SEHAT CIBINONGJL. MAYOR OKING NO 510 (SAMPING
SEKOLAH MARDI WALUYA)IBU YASIKA/ RIRIN MARKETING 021-70230178| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
631 1832 KLINIK PELITA SEHAT BANGBARUNGJL. ACHMAD SOBANA/ BANGBARUNG
77 BOGOR- - 0251-8362525| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
632 1833KLINIK PELITA SEHAT TAMAN
KENARI
RUKO PERUMAHAN TAMAN KENARI
BLOK E3 NO 4, TANAH BARU BOGOR- - 0251-8664767| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
633 1823 KLINIK SALSABILA MEDICAL CENTRE
JL. KSR DADI KUSMAYADI RUKO
LAMPU MERAH CIKARET NO. 70
CIBINONG-BOGOR
IBU SHELLY - 021-87905768| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
634 1913 KLINIK PURI MEDIKAJL. RAYA CIKARET NO. 12 CIBINONG,
BOGOR- -- 021-87903120| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
635 2116 RS. HERMINA MEKARSARIJL. RAYA CILEUNGSI - JONGGOL KM 1
KABUPATEN BOGOR 16820
DRG. EROS SYAH
WORONGAN, MARS.- 021-29232525| 021-2923770 Y Y Y ACTIVE ALL COVERAGE
mekarsari@herminahospitalgrou
p.com
636 0720 RSIA. CITRA INSANI
JL. RAYA PARUNG NO.242,
LEBAKWANGI PEMAGARS. ARI, PARUNG
BOGOR
DR. FERDINAND Y H
SMARKETING
0251 -
8611507/86177270251-
611507|0251-611507
0251 - 8617493 Y Y Y ACTIVE ALL [email protected]
.id
637 1952 KLINIK & APOTEK KF 50 JL. MERDEKA NO 24 BOGORDRS. HENDI
WIJAYA, APT- 0251-8384247 / 8321525| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
638 1385 RS. SENTRA MEDIKA CIBINONGJL. MAYOR OKING JAYA ATMAJA NO.9
CIBINONG
IBU DEVI IBU DEA /
IBU TRI ANA
DARMAWANTI
MARKETING 021-87909999/87911212| 021-87909377 Y Y Y ACTIVE ALL [email protected]
om
639 0755 RS. BINA HUSADA CIBINONGJL. MAYOR O KING NO.101, CIBINONG -
BOGORDR.YUNI MARKETING
021-8758441; 87911000021-
8753422-|021- 8753422-021-8752463 Y Y Y ACTIVE ALL COVERAGE
640 1583 KLINIK TLAJUNGJL. MERCEDES BENZ NO. 79 GUNUNG
PUTRI BOGORDR. SUMARNI - 021-8675604| 021-8675604 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
641 1679 RSIA. ANNISA CITEUREUPJL. KARANGGAN NO 02 PUSPASARI
CITEUREUP - BOGOR
DR. DENI/BPK
HENDRYMARKETING 021-8756780; 8752628| 021-8752628 Y Y Y ACTIVE ALL COVERAGE [email protected];
642 1680 RSIA. SENTOSA JL. RAYA KEMANG NO 18 BOGOR BPK JAYNUDIN MARKETING 0251-7541900| 0251-7541900 Y Y Y ACTIVE ALL [email protected]/biancak
643 1673 RB. PELITA SEHAT POMADJL. RAYA CIBULUH RUKO NO 9
SIMPANG POMAD KEC BOGOR UTARAIBU LINA Marketing
0251-8652628; 0251-
8658811|0251-8658811 Y Y Y ACTIVE ALL COVERAGE [email protected]
644 1662 RSIA. KENARI GRAHA MEDIKAGRIYA KENARI MAS BLOK B2
CILEUNGSIIBU KINING MARKETING
021-
8230426/82499885/966840
76|
021-8231829 Y Y Y ACTIVE ALL COVERAGE [email protected]
645 1419RB & KLINIK CITAMA KEDUNG
WARINGIN GRAVERIJL. BOJONG GEDE-BOGOR IBU DARNI / MANDA KOORDINATOR 021-87983434| Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
646 1297 RB & KLINIK INSANI JL. PAHLAWAN NO.73B CITEUREUP IBU SRI KEUANGAN 021.70247742/ 87942723| 021-87942570 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
647 1353 RS. CITAMAJL. RAYA PABUARAN NO. 52
BOJONGGEDE-BOGOR
IBU MANDA / IBU
TRIMARKETING 021-87985555| 021-87986666 Y Y Y ACTIVE ALL COVERAGE [email protected]
648 1533 KLINIK DR.BETTYJL. RAYA NAROGONG, PERUMAHAN
PT.SEMEN CIBINONG, CILEUNGSIIBU HANNA/Shinta KOORDINATOR 021-82493032| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
649 1484 RB & KLINIK TRIMITRAJL. RAYA GUNUNG PUTRI KM 117,
GUNUNG PUTRIIBU EVA MARKETING 021-8672005| - Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
-
650 0133 RSIA. HERMINA BOGORJL. RING ROAD-1, KAV.23,25,27,
PERUM. TMN. YASMIN
DRG. RETNO/ IBU.
ROLLIMARKETING 0251-8382525| 0251-8328252 Y Y Y ACTIVE ALL COVERAGE
m
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 24 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI651 0932 KLINIK MHT CIPAYUNG JL. RAYA PUNCAK CIPAYUNG
BPK NUGRAHA/ BPK
ANDREADM/ marketing 0251-8256172-|- 0251-8257648 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
652 1103 RS. TRIMITRA CIBINONG JL. RAYA CIBINONG KM.43IBU WIDI/
BPK.MASOEDMARKETING
021-8763055-56021-
8765993|021-8765993021-8758038 Y Y Y ACTIVE ALL COVERAGE [email protected]
653 1134 RB. KLINIK HARAPAN IBUJL. RAYA CIKABON NO.108 PARUNG
PANJANG
IBU UBUN NINGSIH
/ LIAPIMPINAN
021-54260635 /
089664392582/0896421489
75|
021-54260635 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
654 1251 KLINIK INSANI CIBINONGJL. MAYOR OKING, NO.58A, CIRIUNG,
CIBINONGIBU SRI KEUANGAN 021-8757567| 021-8757567 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
655 0290 RS. MARY CILEUNGSI HIJAUJL. RAYA NAROGONG, KM.21,
CILEUNGSI
BAPAK ARIF/TEGUH
WARDOYOMARKETING 021-82492222| 021-82493902 Y Y Y ACTIVE ALL COVERAGE [email protected]
656 0411 RS. AZRA JL. RAYA PAJAJARAN, NO.219RUSLI / PUTRI
MAKARTIMARKETING 0251-8318456-|-
0251-
8331773/8324093Y Y Y ACTIVE ALL COVERAGE
657 0706 POLIKLINIK CIBULUH JL. KEDUNG HALANG TALANG, NO.148 IBU IYAN ROHYANI MARKETING 0251-8661947| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
658 0389 RS. MH THAMRIN CILEUNGSIJL. RAYA NAROGONG, KM.16, LIMUS
NUNGGAL, CILEUNGSI
BPK JANI / IBU
RATNAMARKETING
021-8235052 /
82491332021-
82491332|021-82491332
021-82491331 Y Y Y ACTIVE ALL COVERAGE [email protected];
659 0190 RS. ISLAM BOGORJL. PERDANA RAYA NO.22, BUDI
AGUNG - KEDUNG BADAK
IBU. GINA /
IBU.DIAHMARKETING 0251 - 8316822, 834713| 0251 -8347139 Y Y Y ACTIVE ALL COVERAGE
[email protected];rsislambog
660 0835RS. FAMILY MEDICAL CENTRE
BOGOR
JL. RAYA BOGOR KM.51 CIMANDALA-
SUKARAJADEBORA
HUMAS dan
MARKETING(0251) 8652391| 0251-8661 605 Y Y Y ACTIVE ALL COVERAGE
[email protected];debora0110@y
ahoo.com,
CIAMIS
661 1104 RS. PERMATA BUNDA CIAMIS JL. MR.IWA KUSUMASOMANTRI NO.1IBU HJ NANI
WARNIDAHMARKETING
0265-771650/7767450711-
356173|0711-3561730265-777658 Y Y Y ACTIVE ALL COVERAGE [email protected]
CIANJUR
662 2123 KLINIK PADJADJARAN SUKANAGARAJL. RAYA SUKANEGARA KM.45
SUKANEGARA - CIANJURIBU RIRIN KOORDINATOR
0263-340189/
085794056664|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
663 2121 KLINIK ASSALAM CIKALONGJL. RAYA CIKALONG KULON NO. 61 A
KAB. CIANJURBPK RAGA KOORDINATOR
0263-318222 /
081290995603|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
664 4107 RS. DR.HAFIZJL. PRAMUKA NO. 15 SUKAMULYA,
KARANG TENGAH, CIANJUR
IBU LESSY YANI
RUSLAN- 0263-2910000| (0263) 2910010 Y Y Y ACTIVE ALL COVERAGE [email protected]
CIKAMPEK
665 1409 RSU. PURI ASIH JATISARIJL. RAYA JATISARI NO.3 PASAR
JATISARIIBU ELLA MARKETING 0264-361459/361466| 0264-8375276 Y Y Y ACTIVE ALL COVERAGE [email protected]
666 1239RUMAH SAKIT IZZA D/H (RSU. AQMA
CIKAMPEK)
JL. KP.CISELAN DS.CIKAMPEK
UTARA.KARAWANG
BPK. ANDRI /BPK.
ALIKOORDINATOR 0264-319307/8386830-32| 0264-8386829 Y Y Y ACTIVE ALL COVERAGE [email protected]
667 2445 RS. TITIAN BUNDA JL. IR. H. JUANDA NO.123 CIKAMPEK RIZAL S. NASUTION Marketing (0264) 8385999/8386222| (0261) 8388936 Y Y Y ACTIVE ALL [email protected];
668 2472 RB & KLINIK NAURAH MEDIKAJL. A. YANI NO.02 RT.03 RW. 06 DS.
CIKAMPEK SELATAN, CIKAMPEKIBU YUNI - (0264) 8389999| - N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
669 1749 NAGASARI JL. JEND A. YANI NO 177 CIKAMPEK IBU IIS - 0264-316203| 0264-316203 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
670 1172KLINIK PUTRA MEDIKA ( GROUP
AQMA PUSAT )
JL. IR. H. JUANDA NO.14-19
SUKASEURI
BPK AGUS /
DHENI/DR.HJ
ISWADI
KOORDINATOR 0264-301652 / 8387129| 0264-8387129 N Y Y ACTIVE ALL COVERAGE [email protected]
671 0375 RS. KARYA HUSADAJL. JEND. A.YANI, NO.98, CIKAMPEK-
KARAWANGIBU YUYUN/FITRI MARKETING 0264-316188-89|
0264-
312834/301626Y Y Y ACTIVE ALL COVERAGE [email protected]
672 0540 RS. SARASWATIJL. JEND. A.YANI, NO.92, DAWUAN,
CIKAMPEK-KARAWANGIBU. AGNES/ANI MARKETING
0264-311531/316101/
311514/ 3115270264-
316391|0264-316391
0264-311531 Y Y Y ACTIVE ALL COVERAGE [email protected]
673 1497 KLINIK SEHATJL. PAWARENGAN NO. 37, DESA
DAWUAN TIMURBPK.FAUZI MARKETING 0264-8385103| 0264-8385103 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
m
674 1302 KLINIK PURI ASIH CIKAMPEK JL. STASIUN NO.2 CIKAMPEK KOTA IBU ELLA KOORDINATOR 0264-303558| 0264-303558 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
675 1300 KLINIK ANDINA CIKAMPEK JL. IR.H.JUANDA NO.17 DR.PUR ANA AISTU KOORDINATOR 0264-303759| 0264-8387680 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
676 0908 KLINIK KELUARGA GRAHA MEDIS JL. ACHMAD YANI NO. 51BPK.
CIPTO/DR.DIAHKOORDINATOR 0264-310101| 0264-310101 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
677 0093 KLINIK AQMA CIKAMPEK JL. STASIUN, NO.93 BPK.AGUS MARKETING 0264 - 310 524| 0264 - 319307 N Y Y ACTIVE ALL COVERAGE [email protected]
CIKARANG
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 25 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI678 0738 RS. AMANDA CIKARANG SELATAN
JL. RAYA SERANG NO.38 CIKARANG
SELATAN
DR.SULASTRI / IBU.
DIANMARKETING
021-8971643021-
89110011|021-89110011021-8970808 Y Y Y ACTIVE ALL COVERAGE
[email protected]/dr_la
679 0660RS. PERMATA KELUARGA LIPPO
CIKARANG d/h RS Harapan
JL. MH.THAMRIN,KAV.129, LIPPO
CIKARANGWulan / Ryan MARKETING 021-8990 5588/ 8990 1927|
02189901860/899
01902Y Y Y ACTIVE ALL COVERAGE [email protected]
680 0845 RS. SETIAJL. RAYA SERANG - CIBARUSAH NO.41
BEKASIBPK.DEDEN
kerjasama
asuransi021-8971240/70207424-|- 021-8975249 Y Y Y ACTIVE ALL COVERAGE [email protected]
681 1567 RB & KLINIK PUTRA MEDIKA
JL. N. PERUM VILA MUTIARA, KAMPUNG
KUKUN CIKARANG NO.115 RT.012/06
DS.CIANTAR
DR MULYANA DIREKTUR021-89677215;
02189677628|021-89677216 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
682 1287RB & KLINIK NIZA ASYIFA BERSAMA
1
PERUMAHAN TELAGA HARAPAN BLOK
E1 NO.1 CIKARANG BARATIBU ENDANG ADM 021-89109638| 021-89109638 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
683 1308 RS. RIDHOKA SALMA JL. IMAM BONJOL NO.7 GARDU SAWAH IBU ENDAH KEMALA MARKETING 021-89116527| 021-89116528 Y Y Y ACTIVE ALL COVERAGEhumasmarketingridhokasalma@
ymail.com
684 1494 RB & KLINIK ANNISA IVJL. RAYA CIBARUSAH NO.63 SERANG
BARUIBU INDRI ADMINISTRASI 021-89954434| 021-89954434 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
-
685 1523 RSIA. NURUL ANNISA
JL. RAYA CIKARANG CIBARUSA NO 88
DS. SUKARESMI CIKARANG SELATAN,
BEKASI
IBU.NOVI MARKETING 021-897 4854/55| 021 - 8971122 Y Y Y ACTIVE ALL COVERAGE [email protected]
686 1462 RS. MITRA KELUARGA CIKARANG JL. INDUSTRI RAYA, LEMAH ABANGDR. WIDYA RETNO
W/ IBU MARIAMARKETING 021-89840500/89840900| 021-89845489 Y Y Y ACTIVE ALL COVERAGE
om
687 0306 RS. ANNISA CIKARANGJL. CIKARANG BARU, NO.31,
LEMAHABANG, CIKARANG UTARAdr. resti MARKETING
021-
8904165/8901962/8904503
021 - 8904503|021 -
8904503
021-
8903350/8911382
7
Y Y Y ACTIVE ALL COVERAGEmarketing@rsannisa-
cikarang.com
688 0385 RS. BHAKTI HUSADA JL. RE. MARTADINATA IBU ADITYA MARKETING021-8900530/1021-890
0531|021-890 0531021-8900570 Y Y Y ACTIVE ALL COVERAGE
m
689 1034 KLINIK HARAPAN SEHAT II
RUKO TELAGA HARAPAN BLOK F NO.16,
PERUMAHAN TELAGA HARAPAN,
CIKARANG BARAT
DR. ERNA MARKETING 021-8904519-|- - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
690 1041RS HARAPAN KELUARGA (d/h
RS.HARAPAN INTERNASIONAL)
JL.KASUARI RAYA KAV.1A-1B, KOTA
JABABEKA, CIKARANG BARUbpk Ervan MARKETING 021-89840745|- 021-89835839 Y Y Y ACTIVE ALL COVERAGE
691 0850KLINIK BERKAT MELIMPAH JABABEKA
(HOSANA MEDIKA II)
JL. KAWASAN INDUSTRI I, JABABEKA
B8, CIKARANG UTARA
DRG.SHINTA/DR
ISKANDAR
PELAYANAN
PASIEN
021-8937941021-
8937942|021-8937942
021-
8937942,8983305
5
N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
692 1050 RSIA. AMANDA CIKARANG UTARAJL. RAYA INDUSTRI NO.36,CIKARANG
UTARADR. SULASTRI MARKETING
021- 8900277 /
89110011021-8900277|021-
8900277
021-89110011 Y Y Y ACTIVE ALL COVERAGE [email protected]
693 0913 RS. ASRI MEDIKAJL. CITANDUY RAYA BLOK L II NO.1
CIKARANG UTARAIBU WULAN MARKETING 021-89142968, 89142969-|-
02189143860/891
43036Y Y Y ACTIVE ALL COVERAGE
[email protected]/rsia
694 0929 KLINIK RENNICHA PUTRAJL. RAYA CIKARANG CIBARUSAH NO 89
LIPPO CIKARANGBPK TARMUDJI MARKETING
021-8971852021-
8971658|021-8971658021-8971852 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
695 0960 RSB. MEKAR MULIAJL. KASUARI IV, SEKTOR MEKAR
ALAM,PASIMAL - CIKARANG BARUDR YENNI KOORDINATOR 021-8936940/66-|- 021-89830523 Y Y Y ACTIVE ALL COVERAGE
rsb.mekarmuliacikarang@yahoo.
com
696 0966 RB & KLINIK CENTRAL MEDIKAJL. PILAR - SUKATANI, DS SUKARAYA
NO 84, KARANG BAHAGIATEJA, ISKANDAR MARKETING 021- 89111103-|- 021-89119714 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
697 0967 CITRA ARDHITA MEDIFARMACAPITOL BUSINESS PARK, BLOK B2, JL.
NIAGA RAYAIBU LISTI/ SUTOMO
MARKETING/
Direktur
021-89831945/7004236021-
89831946|021-89831946
02189831946/898
33385N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
698 1119 KLINIK SAPTA MITRA CIKARANGJL. RAYA CIKARANG - CIBARUSAH,
NO.39A, SUKARESMIBPK.ROBY CLINIC MANAGER 021-8975369| 021-8975369 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
699 1218 KLINIK CIKARANG MEDIKA JAYA JL. YOS SUDARS. O NO.27 CIKARANG BPK.WIJAYA / NOVI Pemilik/ Marketing 021-8900129| 021-8901318 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
700 0263 RB & KLINIK YAYASAN BINA MEDIKA KP. KONGSI, CIKARANG IBU SULASTRIPELAYANAN
PASIEN
021-8900050021-
8900051|021-8900051021-8900051 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
701 0391SILOAM HOSPITALS LIPPO
CIKARANG
JL. MH. THAMRIN, KAV.105, LIPPO
CIKARANG
DR.SISKA/IBU
RESTI/VICKY PMARKETING 021- 29636900|
021-
89900022/897247
0
Y Y Y ACTIVE ALL COVERAGE [email protected]
702 0406 KLINIK ANNISA II (CIKARANG) JL. CIBARUSAH RUKO POIN, NO.31 R BPK DADANGPELAYANAN
PASIEN021-8976189| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
703 2454RS. HOSANA MEDIKA CIKARANG
BARU
JL. ANGGREK I B2/2 RT.01/11 DS.
MEKARMUKTI - CIKARANGIBU ERNA MARKETING (021) 89835223| 021-89830442 Y Y Y ACTIVE ALL COVERAGE [email protected]
704 2510 MITRASANA TAMAN ASTERRUKO TAMAN ASTER KAV. A3 NO. 41
TELAGA ASIH CIKARANG BARAT- - 88333364| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
705 2462KLINIK 24 JAM & RB. PERMATA
BUNDA CIKARANG
RUKO GRAMA NIAGA H2 NO. 15/15A,
KARANG ASIH - CIKARANG UTARAIBU ZENDRI -
021 - 2928 2165, 021 -
2928 2166|- N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 26 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI706 2464 MITRASANA PT
RUKO PLAZA ROXY BLOK C NO. 8 JL.
KASUARI RAYA, KOTA HIJAU JABABEKA,
CIKARANG BARU
IBU ENDAH - 021-89835394| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
707 1824 KLINIK BUNDA AULIAJL. HAJI RATIM NO. 143 DS JATIWANGI
CIKARANG BARAT - BEKASIBP. RAMA/ YOLANDA Marketing
021-8998 3742 / 2897
3209|021-8998 3742 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
708 0275 RS. SENTRA MEDIKA CIKARANGJL. RAYA INDUSTRI PASIR GOMBONG
JABABEKA, CIKARANGIBU HENI MARKETING
021 8904160-64 / EXT
225/081297102702|
021-
8904159,8911111
2
Y Y Y ACTIVE ALL COVERAGE [email protected]
709 2061 RS. BUDI ASIH CIKARANG
JL. RAYA SERANG - CIBARUSAH RT 01/
RW 01 SERANG KEC.CIKARANG
SELATAN,BEKASI
BPK. CITRA Marketing 021 - 896 777 95| - Y Y Y ACTIVE ALL COVERAGE [email protected]
710 2087 KLINIK JB MEDICAL CENTERSHOP HOUSE PERMATA JUNCTION
BLOK B A-15 JABABEKA 1 CIKARANGICUK SUGIARTO MARKETING 021-89846023/24| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
711 2034 RSIA. CIKARANG MEDIKAJL. KH. FUHDOLI NO.78 KAMPUNG
KAUM CIKARANG UTARA, BEKASIBPK WAWAN - 021-8902210| 021-82607637 Y Y Y ACTIVE ALL COVERAGE [email protected]
712 1962 KLINIK & APOTEK KEMALAJL. TARUM BARAT 2, RUKO GRAND
ARTHA NIAGA 2 BLOK O2 NO. 23 - 23ADENI ABDURAHMAN Marketing 021-29083377 - 29083376| 021- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
713 0574 RB & KLINIK BUDI LUHUR
JL. RAYA IMAM BONJOL, NO.74,
RT.07/04, DESA
SUKADANAU,CIKARANG BARAT
BPK EKO KOORDINATOR 021- 88327226/88320116| 021-88327226 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
714 1719CMC CLINIC ( CIKARANG MEDICAL
CENTER )
SHOPHOUSE BLOK A NO 14-15, 28-29
JL. JABABEKA RAYA KAWASAN
INDUSTRI CIKARANG
IBU TIRA/BP BUDI MARKETING 021-8934371| 021-8934035 N Y Y ACTIVE ALL [email protected]/tirrad
715 1795 RB. KHANZA MEDIKAPERUM KOTA SERANG BARU BLOK B 72
NO 25-26, CIKARANGDARWIS - 021-91263025| 021-89953117 N Y Y ACTIVE ALL COVERAGE [email protected]
716 1842 RS. MEDIROSSA 2
JL. RAYA CIBARUSAH DESA
SINDANGMULYA KEC. CIBARUSAH
BEKASI
BPK OMAN Marketing 021-89955555| 021-89952355 Y Y Y ACTIVE ALL [email protected]
om
717 1415RB & KLINIK PERMATA BUNDA
FUDHOLI
JL. KH.FUDHOLY NO 11 KARANG ASIH,
CIKARANG UTARABPK.RUWIK - 021-8910080| - Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
718 1234RS. DR. SANDER B (D/H RS. HOSANA
MEDICA PILAR)
JL. K.H.DEWANTARA NO.33,DS KARANG
ASIH,CIKARANG UTARA
ODZIARMAN SE, IBU
UNTARI, BPK RIFKIHRD 021-89116176 / 77 / 78| 021-89116179 Y Y Y ACTIVE ALL COVERAGE [email protected]
719 1064KLINIK KASIH ANUGERAH SERANG
BARU (HOSANA MEDIKA C
JL. RAYA SERANG-CIBARUSAH
KP.BUNISARI RT.07/04 DS.SUKARAGAM
SERANG BARU
IBU YATRI/ DR.
THERESIAKOORDINATOR
021-
89952605,89952612021-
89952612|021-89952612
021-89951205 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
720 1067 RS. MEDIROSSAJL. INDUSTRI TEGAL GEDE - CIKARANG
SELATAN
BPK. KUJANG-IBU
DEWIMARKETING 021-89833216| 021-8934979 Y Y Y ACTIVE ALL COVERAGE [email protected]
721 1514 KLINIK SUMBER WARAS
JL. RAYA CIBARUSAH, KAMPUNG
CIJAMBE, SUKADAMI, CIKARANG
SELATAN
IBU NOVIANTI MANAGER KLINIK 021-8970524| 021-8970524 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
d
722 2505 MITRASANA MEGA REGENCY
RUKO KOTA MEGA REGENCY BLOK A 01
NO. 10, JL. RAYA CIKARANG -
CIBARUSAH KM 10
- - 70326665| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
723 2742 KLINIK SUMBER SEHATJL. KI FUDOLI RT.001/001 CIKARANG
UTARAIBU NOVI (021) 8900566, 68416442| (021) 8900566 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
d
724 0916 RB & KLINIK GRAHA BINA HUSADAJL. INDUSTRI SELATAN NO.1A, BLOK
NN 3A, INDUSTRI JABABEKA IIBAPAK BUDI Koordinator 021-89836243-|- 021-89836244 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
725 2496 KLINIK INSPIRA SABILA MAKMURRUKO MELAWAI BLOK A NO. 12 TLH
LIPPO CIKARAN
BPK ROCKY/ DR.
MASRULLOH- 085100990164| 2189903336 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
m
726 3992 KLINIK CENTRAL MEDIKA 3
JL. RAYA RENGAS BANDUNG NO.20
001/003,KARANG SAMBUNG,KEDUNG
WARINGIN,BEKASI
BP. RISKANDAR MARKETING 021-89142220| 021-89142221 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
727 2975 KLINIK PUTRA MEDIKA 3
JL. PERUM KOTA SERANG BARU, KP.
GEBANG DS. SUKARAGAM KEC.
SERANG BARU, BEKASI
DR. MULYANA
PANIJAOWNER (021) 89950333| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
728 2058 RSIA. GIZAR
JL. VILA MUTIARA CIKARANG, RUKO
PASADENA BLOK RA NO. 3, 5, 6
CIANTRA, CIKARANG SELATAN
TRIANA SINTAWATI,
SP- 021-89677240 / 89677204| 021-89677239 Y Y Y ACTIVE ALL COVERAGE [email protected]
729 0709 RS. HOSANA MEDICA LIPPOJL. UTAMA BIIE NO 01 LIPPO
CIKARANG
IBU DELIMA/IBU
DEWIMARKETING 021-8972472| 021-89900769 Y Y Y ACTIVE ALL COVERAGE [email protected]
CIMAHI
730 0268 RS. MITRA KASIH JL. RAYA CIBABAT NO.341, CIMAHI DR. RIZKI MARKETING022-
6654852,6652774,6654397|
022-
6654875/6642349Y Y Y ACTIVE ALL COVERAGE [email protected]
731 2221 RS. AVISENAJL. MELONGASIH NO. 170 CIJERAH -
CIMAHIBP HENDAR - 022 - 6000830| 022-6000830 Y Y Y ACTIVE ALL COVERAGE
[email protected]/Rsavisena@
gmail.com
732 2467 RSU. KASIH BUNDAJL. MAHAR MARTANEGARA NO.166
LEUWIGAJAH - CIMAHI 40521
IBU DWI
SUPRIATINIMARKETING 022- 6614221/ 6630585| 022- 6630583 Y Y Y ACTIVE ALL COVERAGE
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 27 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALICIREBON
733 2690 KIMIA FARMA 40 JL. PARUJAKAN NO.12 , CIREBON DRS. ALFIAN, APT. - 0231-208954| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
734 2378RS. KHUSUS JANTUNG HASNA
MEDIKA
JL. RD GILAP NO. 8 PALIMANAN TIMUR,
KABUPATEN CIREBONPAK UKON MARKETING 0231-343405; 343645| 0231-342224 Y Y Y ACTIVE ALL COVERAGE [email protected]
735 1029 RS. SUMBER WARAS CIWARINGINJL. URIP SUMOHARJO, NO.5,
CIWARINGINYUDITH MAROLITHA -
0231-
341079,3300888,341079-|-0231-342112 Y Y Y ACTIVE ALL COVERAGE [email protected]
736 3882 RSIA. CAHAYA BUNDAJL. RAYA PERJUANGAN NO.8 KESAMBI
CIREBONDADI YUDI HUMAS 0231-8333388 / 99| 0231-482121 Y Y Y ACTIVE ALL COVERAGE
marketing@rsia-
cahayabunda.com
737 2180 APOTEK FARMARIN CIREBON JL. KESAMBI RAYA NO. 92 A
YULIA SOPI
KUSDIANI, S.SI,
APT
- 08179416709| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
738 0293 RS. PELABUHAN CIREBON JL. SISINGAMANGARAJA, NO.45 IBU YENNY MARKETING
0231-208948/208680 /
0231-2056570231-
205657|0231-205657
0231-234670 Y Y Y ACTIVE ALL [email protected];
739 1091 RS. PUTERA BAHAGIA JL. CIREMAI RAYA NO.114 ,PERUMNAS IBU NINIK RIZKY HUMAS0231-207351, 4856540231-
485654|0231-485654
0231-
486356/482328Y Y Y ACTIVE ALL COVERAGE
[email protected]/rspb_
740 1174 RS. SUMBER KASIH JL. SILIWANGI NO.135IBU IKAH/ BPK.
AGUSMARKETING 0231-203815| 0231-210040 Y Y Y ACTIVE ALL COVERAGE
m
741 1316 RS. MITRA PLUMBON JL. RAYA PLUMBON, KM.11 IBU SHINTA NORA PEMASARAN 0231-324483/323100|0231-
322355/322066Y Y Y ACTIVE ALL COVERAGE [email protected]
742 0602 RS. PERTAMINA CIREBON JL. PATRA RAYA, KLAYAN
IBU
DHARLIANTI/BPK.M.
NUR
MARKETING0231-224646; 25121730231-
224646|0231-224646
0231-224795;
209328Y Y Y ACTIVE ALL COVERAGE [email protected]
DEPOK
743 0107 RS. SIMPANGAN DEPOKJL. RAYA BOGOR, KM.36, SIDAMUKTI
SUKMAJAYA, CIMANGGIS - DEPOK
ENDANG
ARTININGSIHMARKETING 021-8741549| 021-8741574 Y Y Y ACTIVE ALL COVERAGE [email protected]
744 3329 KLINIK AL-ZAMZAMJL. ABDUL GANI NO. 53, CILODONG,
DEPOKIBU NOVI MARKETING (021) 77841431; 87904855| (021) 87904855 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
745 1485 RS. MITRA KELUARGA DEPOKJL. MARGONDA RAYA, PANCORAN MAS -
DEPOK
DR. NENDYA
LIBRIYANI/IBU
AYU/MALA
MARKETING 021-77210700| 021-77212155 Y Y Y ACTIVE ALL COVERAGEmarketingdepok@mitrakeluarga.
com
746 1085 RS. MEILIAJL. ALTERNATIF CIBUBUR KM.1
CIMANGGIS DEPOKIBU RISKA MARKETING 021-8444444,84598954-|- 021-84598952 Y Y Y ACTIVE ALL COVERAGE [email protected]
747 1098 RS. GRHA PERMATA IBU JL. KH. M. USMAN 168,KUKUSAN BEJIIBU IRA/IBU
TITA/DR DEWIMARKETING 021-7778899-|- 021-7778998 Y Y Y ACTIVE ALL COVERAGE [email protected]
748 0009 RSU. BHAKTI YUDHA JL. RAYA SAWANGAN-DEPOKDRG.WIEN
PRATIWI/ IBU YANIMARKETING 021-7520082|
021-
7775862/7762880Y Y Y ACTIVE ALL COVERAGE [email protected]
749 0777 RSIA. TUMBUH KEMBANGJL. RAYA BOGOR, KM.31, NO.23,
CIMANGGIS
BPK. TAUFIQ
ISKANDAR/
BPK.AGUS
MARKETING021-8701873-74021-
8712300|021-8712300021-8701872 Y Y Y ACTIVE ALL COVERAGE
.id
750 0776 RS. PURI CINEREJL. MARIBAYA BLOK F2, NO.10, PURI
CINERE - DEPOKBPK RONALD MARKETING 021-7545488| 021-7545486 Y Y Y ACTIVE ALL COVERAGE
[email protected]/ronalsima
751 0470 RS. SENTRA MEDIKA DEPOKJL. RAYA BOGOR KM.33 CISALAK -
DEPOK
IBU SEFTYA
WILDA/DEVI/RIAMARKETING 021-874 3790|
0218743230/8774
1666Y Y Y ACTIVE ALL COVERAGE
marketing@sentramedika-
cisalak.co.id
752 0346 RS. TUGU IBUJL. RAYA BOGOR, KM.29, CIMANGGIS -
DEPOK
DRG.MEGA /
IBU.EKAMARKETING
021-8710870/021-
8718634/33|021-
8718634/33
021-8708266 Y Y Y ACTIVE ALL COVERAGE [email protected]
753 2630 KLINIK & APOTEK KF 202 JL. KEJAYAAN BLOK IX NO. 2, DEPOK
DRS. GUNAWAN
RACHMAT BUANA
APT
- 0217704044| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
754 2627 KLINIK & APOTEK KF 352 JL. MARGONDA RAYA, DEPOK APRIYANDI - 02178884611| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
755 2628 KLINIK & APOTEK KF 394 JL. SILIWANGI NO.35, DEPOKSYAHRI APRIYANTO
S.FARM, APT- 02177214567| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHARkf.siliwangi@yahoocom
756 2460 KLINIK UTAMA TUGU SAWANGANJL. RAYA MUCHTAR NO. 20 RT.002/007
SAWANGAN - DEPOK 16511
IR. ASNIM
SJAKRANI, MBADIRUT
0251-8613433/021-
29420173|0251-8613433 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
757 2090 KLINIK QITAJL. SEDAP MALAM RAYA NO. 5 KOMP.
PERTANIAN DEPOK, CITAYAM- - 021-87989096| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
758 2078 APOTIK FARMARIN V DEPOKRUKO SALADIN SQUARE C27 JL.
MARGONDA RAYA DEPOKNABILA - 021-29402214| 021-29402214 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
759 1950 KLINIK & APOTEK KF 143 JL. MARGONDA DEPOK HASTUTI ASSAURI - 021-7522997| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
760 1056 RS. BUNDA MARGONDAJL. MARGONDA RAYA NO.28 PONDOK
CINA-DEPOK 16424LELI AR 021-78890551-|- 021-78889958 Y Y Y ACTIVE ALL COVERAGE
761 1318 RB & KLINIK CITAMA CIPAYUNGJL. RAYA CIPAYUNG NO.27 PANCORAN
MAS DEPOKBP JEN Koordinator
021-87989203/5-021-
87982268|
02187986666/828
2869Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 28 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI762 1615 RSIA. ASY SYIFA MEDICAL CENTER
JL. CINERE DEPOK NO 9 RANGKAPAN
JAYA BARU PANCORAN MAS, DEPOKIBU IKA / IBU ENO MARKETING 021-77883905/77885454| 021-77885454 Y Y Y ACTIVE ALL COVERAGE
[email protected]/rey-
763 0265 RS. HERMINA DEPOKJL. RAYA SILIWANGI, NO.50,
PANCORAN MASIBU OPPY MARKETING 021-77202525| 021-7763309 Y Y Y ACTIVE ALL COVERAGE
m
764 1776KLINIK UTAMA RAWAT INAP NAURA
MEDIKA
JL. KEMAKMURAN RAYA NO 37 DEPOK
IIIBU LIZA marketing 021-77827515| 021-77824756 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
marketing_nauramedika@yahoo.
com
765 1266 RB & KLINIK EL RAPHAJL. RAYA BOGOR KM 30 CIMANGGIS -
DEPOK
IBU PAULINA / IBU
YUSTINPemilik 021-8715082| 021-8715082 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
766 1194 RS. HASANAH GRAHA AFIAH JL. RADEN SALEH NO.42 DEPOKIBU IRS. YA/RENDY
ADITYAMARKETING 021-77826267/ 77826276| 021-77833796 Y Y Y ACTIVE ALL COVERAGE
767 2760 RS. CITRA MEDIKA DEPOKJL. RAYA KALI MULIA NO. 68 KOTA
KEMBANG, CILODONG, DEPOK
IBU ROSI/IBU
ROBIATULMARKETING
021-
29671000/5000/7000/8000|021-29678000 Y Y Y ACTIVE ALL COVERAGE
768 2722 RS. PERMATA DEPOKJL. RAYA MUCHTAR NO. 22 SAWANGAN
DEPOKLINA MARKETING 021-29669000| 021-29668897 Y Y Y ACTIVE ALL COVERAGE
m;
769 1094RS. KHUSUS JANTUNG DIAGRAM
DEPOKJL. MARIBAYA NO.1 PURI CINERE
IBU ELIS / IBU
WITTY
PUBLIC
RELATIONS021-7545499-|- 021-7536965 Y Y Y ACTIVE ALL COVERAGE
Elisabeth.Paramita@siloamhospit
als.com
770 2806 KLINIK PERTAMEDIKA CINERE JL. CINERE RAYA NO. 11BDINI
(08161352467)- 021-7535022| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
771 2808KLINIK PERTAMEDIKA DEPOK (
MARGONDA)JL. MARGONDA RAYA NO. 270, DEPOK
YANI
(081807285373)- 021-77219363| 021-77219364 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
772 4007KLINIK UTAMA RAWAT INAP LIMO
MEDICARE
JL. MERUYUNG RAYA NO. 70,
PANCORAN MAS, DEPOKIBU K. ICHA DIAN - (021) 77888674; 77888675| (021) 77888675 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
773 2131 KLINIK VIVA MEDIKA DEPOK JL. RA KARTINI NO. 47C/D - - 021-29097508/09| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
774 2478 KLINIK PRATAMA DEPOK DUAJL. H.M. YUSUF RAYA RUKAN DEPOK
DUA NO.11-IBU RIA Markeing (021) 29441366| -021-29441367 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
775 2629 KIMIA FARMA BEJI JL. RAYA NUSANTARA - DEPOKNITYA BRILIANTY,
S.SI, APT- 02177207404| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
776 1007 RS. HARAPAN DEPOK JL. PEMUDA NO.10 IBU DESI PIMPINAN
021-
7520009,7773817,7720000
5-|-
021-7765883 Y Y Y ACTIVE ALL COVERAGE [email protected]
GARUT
777 2120 KLINIK PADJAJARAN LELES JL. RAYA LELES NO. 116 KAB. GARUT BAPAK AGUS - 0262-2458083| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
778 1627 BETHESDA MEDICAL CENTER GARUT JL. CIWALEN NO 43 GARUT BPK ENDY Koordinator 0262-242663,238735| 0262-242663 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
o.id
779 2699 KLINIK & APOTEK KF 377 JL. CIMANUK NO. 11A, GARUT
IKHSAN ANUARI
AKDANI,S.FARM,APT
.
- 0262 233237| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
780 2994 LAB. KIMIA FARMA GARUT JL. CIMANUK 11A PAMINGGIR JUANDA - (0262) 540077| (0262) 540077 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
INDRAMAYUKARAWANG
781 0899 KLINIK AULIA KARAWANGJL. PURWASARI KM 6, PURWASARI -
KARAWANG
IBU SUSI
SUCIATI,SKMPimpinan
0264-8286755 0811
1889279-|-0264-8286756 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
782 0869 RS. DELIMA ASIH SISMA MEDIKAJL. WIRASABA NO.54 JOHAR -
KARAWANG
BPK.SAEFULOH,IRM
AMARKETING 0267-403073-|- 0267-405598 Y Y Y ACTIVE ALL COVERAGE
marketing.rsda@sismame/delim
783 1022 RSU. FIKRI MEDIKAJL. RAYA KOSAMBI- TELAGASARI, DS
BLENDUNG , KLARIIBU YULI MARKETING
0267-8615555/8615566
(KLINIK):0267-
433636/435527-|-
0267-8615577/88 Y Y Y ACTIVE ALL COVERAGE [email protected]
784 1023 RS. ISLAM KARAWANG JL. PANGKAL PERJUANGAN KM.2 BPK TEDY MARKETING
0267-414520, 0267 -
414524, 4145210267-
414524|0267-414524
0267-413277 Y Y Y ACTIVE ALL COVERAGE [email protected]
785 1310 KLINIK ANDINA KARAWANG JL. PANCAWATI, NO.5A, KLARI DR.PUR ANA AISTUR KOORDINATOR 0267-438568| 0267-438406 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
786 1311 KLINIK PURI ASIH KOSAMBI
JL. KOSAMBI NO.08. KP. PUNDONG RT
02/ RW 03 DS. BELENDUNGKECAMATAN
KLARI
IBU ELLA KOORDINATOR 0267-431325 / 8616519| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
787 1314 RSIA. DR. DJOKO PRAMONOJL. PANATAYUDA 1, NO.35, KARAWANG
BARATIBU RIMA MARKETING
0267-
403009/418818/403744|0267-411744 Y Y Y ACTIVE ALL COVERAGE
tomerservice@rs
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 29 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI788 0197 KLINIK GEMPOL
JL. RANGGAGEDE, NO.25 KARAWANG
BARATIBU MARNI KOORDINATOR 0267-412117/8453903| 0267-412117 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
789 1027 KLINIK BINA MEDIKA KARAWANGJL. TELUK JAMBE NO 8, KARAWANG
BARAT
BPK. SUDIARTO /
MAMAN/ WAHYUPENGELOLA
0267-8453903/ 412117 /
08121918055-|-0267 - 641968 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
790 1035 KLINIK MITRA GEMPOL
JL. PROKLAMASI NO. 15 KW 8 RT 003
RW. 005 KEL. TUNGGAKJATI KEC
KARAWANG BARAT KAB. KARAWANG,
BPK.SUGIARTO PIMPINAN 0267- 8451114-|- - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
791 1133 RS. CITO KARAWANGJL. ARTERI TOL KARAWANG BARAT
TELUK JAMBE
BPK.SAMUEL/ IBU
METIMarketing 0267-414245 / 414264| 0267-414306 Y Y Y ACTIVE ALL COVERAGE [email protected]
792 0095 KLINIK GRAHA MEDISJL. RAYA KOSAMBI, NO.23, DUREN
KLARI, KARAWANG TIMURDR.DIAH PERMATA KEUANGAN 0267-435527| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
793 0690 KLINIK YAKESTIJL. RAYA KLARI, RT. 04 / 01,
GINTUNGKERTA KLARIBPK ARIF KEUANGAN 0267-432416| 0267-432416 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
794 0691 KLINIK PURWAMEDIKAJL. RAYA TAMELANG NO.53,
KERAWANGBPK. SUGIARTO KEUANGAN 0267-433653| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
795 0689 KLINIK MITRA SEHAT JL. KOSAMBI CURUG, NO.28, KLARIDR. SUGENG / BPK.
SAPARKEUANGAN 0267-433930| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
796 0704 KLINIK CITO KARAWANG JL. KERTABUMI, NO.29 BPK NURS. ALIM manager 0267-410173/415957| 0267-415957 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
797 1835 KLINIK GRIYA MEDIKA
PERUM GRIYA KONDANG ASRI BLOK T
NO. 01 DESA KONDANG JAYA KEC.
KLARI - KARAWANG TIMUR
RIAL - 0267-8619999| 0267-8615309 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
798 1572 DHARMA DENTAL CLINIC (DDC) JL. KERTABUMI NO 62 KARAWANGBPK KURNIAWAN
GOZALIKOORDINATOR 0267-8453633| 0267-403962 N Y Y PARTIAL DENTAL
nia_maryani@dharmadentalclinic
.com
799 0083 RS. DEWI SRI JL. ARIF RAHMAN HAKIM, NO.1 IBU MIRA/IBU SRI MARKETING
0267-
401475,402855,406445026
7-402147|0267-402147
0267-404010 Y Y Y ACTIVE ALL COVERAGE [email protected]
800 0255 RS. BAYUKARTA JL. KERTABUMI, NO.44Ibu.DWI/Bpk.Indra/
Bpk.SandhyMARKETING
0267-
401817/401818/400351026
7-801818|0267-801818
0267-404472 Y Y Y ACTIVE ALL COVERAGE [email protected]
801 1635 KLINIK MITRA KONDANG UTAMAJL. PENGAIRAN CITRA KEBUN MAS
KONDANG KARAWANGDR. HUDI - 0267-8616923| 0267-8450001 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
802 1058 KLINIK NAFILA MEDIKA
JL. PRINGGODANI BLOK J-47
PERUMNAS TELUK JAMBE, KARAWANG
BARAT
IBU ELI KOORDINATOR 0267-8456419-|- 0267-8456419 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
803 1059 KLINIK PURI ASIH TELUKJAMBEDUSUN SUKAMULYA, DESA
PINAYUNGAN, TELUK JAMBEIBU ELLA KOORDINATOR 0267-646845-|- 0267-646845 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
klinikpuriasih.telukjambe@gmail.
com
804 3369 APOTIK KIMIA FARMA 343JL. KERTABUMI NO 12A KARAWANG
JAWA BARATIBU DEFI - 0267-8453321| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
805 2731 RS. ROSELA
JL. INTERCHANGE TOL KARAWANG
BARAT NO.3 DS WADAS KEC. TELUK
JAMBE
DIAN SANTOSO (
081316245604)MARKETING (0267) 8637207/8637205| 0267 8367205 Y Y Y ACTIVE ALL COVERAGE [email protected]
806 2741 RSIA. MITRA FAMILY-KARAWANG
JL. RONGGOWALUYO RT.02/05 DESA
SUKAHARJA KEC. TELUKJAMBE TIMUR,
KARAWANG
IBU AYU MARKETING0267 - 8458327 , 8458328,
8458329|- Y Y Y ACTIVE ALL COVERAGE
.id;
807 1006RS. CITRA SARI HUSADA (D/H
KLINIK INTAN BAROKAH)
JL. RAYA KOSAMBI-TELAGASARI, KM.3,
KLARI, KARAWANG TIMURIBU SENY (HRD) MARKETING 0267-437507/8617972| 0267-438681 Y Y Y ACTIVE ALL COVERAGE [email protected]
808 2823 RS. LIRA MEDIKAJL. SYECH QURO NO.14 LAMARAN,
KARAWANG - JAWA BARAT
WAHYUANA (0878
8020 8001)- (0267) 8452555 / 405 752| (0267) 405 752 Y Y Y ACTIVE ALL COVERAGE [email protected]
809 2993 KLINIK & APOTEK KF 79 KARAWANG JL. DEWI SARTIKA II NO.30 KARAWANG RIFAI TANJUNG BM 0267-405748| 0267-405748 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected]/kimiafa
KUNINGAN
810 1704 RS. SEKAR KAMULYANJL. RUMAH SAKIT NO 28, CIGUGUR
KUNINGANBPK IRMAN MARKETING 0232-873206| 0232-875516 Y Y Y ACTIVE ALL COVERAGE
m
811 1345 RS. JUANDA KUNINGAN JL. IR. H. JUANDA NO.207 KUNINGAN BP KUSNANTO Marketing 0232-876433/875871|0232-
876433/875871Y Y Y ACTIVE ALL COVERAGE
[email protected];kusnanto_
MAJALENGKAPURWAKARTA
812 0189 KLINIK AQMA PURWAKARTA JL. IBRAHIM SINGADILAGA, NO.14BPK.HUMAIDI/IWAN
/HAMBALI
PELAYANAN
PASIEN0264-200377| 0264-200377 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
813 1057 RSIA. ASRI PURWAKARTAJL. VETERAN CIHIDEUNG NO.15
PURWAKARTA
BPK DIAN / IBU
ANDINAMARKETING 0264-211680-|- 0264-219047 Y Y Y ACTIVE ALL COVERAGE [email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 30 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI814 1043
SILOAM HOSPITAL PURWAKARTA(d/h
RS. EFARINA ETAHAM)
JL. BUNGURSARI NO.1 PO.BOX 167 -
Purwakarta
DR ANANDA ULLI/
MELLYMARKETING
0264-
8628900/8628911|0264-
231273
0264-212674 Y Y Y ACTIVE ALL [email protected]
om
815 1175 KLINIK AQMA PLERED JL. ANJUN NO.96 PLEREDBPK AGUS/ BAPAK
DIDINMARKETING 0264-270830| 0264-270830 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
816 0759 KLINIK MEDIKA SEHAT JL. IPIK GANDAMANAH SUKAMULYA BP AKHMAD JANAN MARKETING 0264-8225017| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
817 1620RS. BHAKTI HUSADA II
PURWAKARTA
JL. RAYA SADANG SUBANG, KP. KIARA
DUA, DS. CIKUMPAY, KEC. CAMPAKAYATI MARKETING
0264-
8225344/8225345/0813733
60783|
0264-8225255 Y Y Y ACTIVE ALL [email protected]/ayi
818 1526 RS. AMIRAJL. IPIK GANDAMANAH RT.035 RW.003
MUNJUL JAYAIBU LIYA
MARKETING PAK
YUSUF0264-8221191/92| 0264-8221193/95 Y Y Y ACTIVE ALL COVERAGE [email protected]
819 1718 RS. KHUSUS BEDAH RAMA HADIJL. RAYA SADANG - SUBANG , DS
CIWANGI BUNGUR SARI PURWAKARTADIAN ISMIATI Marketing 0264 - 202136 / 202164| 0264-8225679 Y Y Y ACTIVE ALL COVERAGE [email protected]
820 4054 KLINIK ANAK MASITHOHKP.KRAJAN RT. 01/01 MARACANG,
BABAKAN CIKAO
IBU DEVI
NOPIYANTIMarketing (0264) 8220544| (0264) 8623240 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
.id
821 2698 KLINIK & APOTEK KF PURWAKARTAJL. VETERAN NO 152 KEL NAGRI KALER
PURWAKARTA ( DEPAN INSPECTORAT )
FIKRI
SHALMANTYAS,S.FA
RM,APT
- 0264 8227437| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
apotek.kimiafarmapurwakarta@
gmail.om
822 1545 RS. MH THAMRIN PURWAKARTA JL. BUNGURSARI, NO.36 IBU.SUSI/BPK KIKI MARKETING 0264-8222222| 0264-8222223 Y Y Y ACTIVE ALL COVERAGE [email protected]
823 1315 KLINIK MIRACLE GROUPKOMP. ANEKA JASA BLOK AII NO.9-10
KOTA BUKIT INDAHBPK. NANO KOORDINATOR 0264-35166, 351377| 0264-351355 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
SUBANG
824 0191RS. PERKEBUNAN NUSANTARA 8
SUBANGJL. OTISTA, NO.1, SUBANG
BPK. IWAN
TRISTIANTOMARKETING
0260-
420406,411632,420306,420
4360260-411632/4|0260-
411632/4
0260-420391 Y Y Y ACTIVE ALL [email protected];amn.rspn8
@gmail.com
825 2752 KLINIK MITRA ABADIJL. KAPTEN HANAFIAH NO.3 RT. 98 RW.
27 KEL. KARANGANYAR, SUBANGIBU NOVAZA - 0260-418247| 0260-418237 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
SUKABUMI
826 0227 KLINIK & RB. PERMATA BUNDA JL. SILIWANGI, NO.64, PARUNG KUDAIBU DR WAYANG /
AFI
KOORDINATOR/
humas0266-535086| 0266-535086 N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
827 1506 RS. KARTIKA MEDICAL CENTER JL. JEND. A.YANI, NO.18 DR.DIAN MARKETING 0266-6250902/6250905| 0266-6250901 Y Y Y ACTIVE ALL COVERAGE [email protected]
828 0056 RS. ISLAM ASSYIFA JL. JEND. SUDIRMAN, NO. 27 MUTIARA FARIZA MARKETING
0266-
222663/218672/241463/22
3742/2237420266-
21343|0266-21343
0266 - 213433 Y Y Y ACTIVE ALL [email protected];pemasa
829 2892 RS. KARTIKA CIBADAKJL. SILIWANGI NO.139, CIBADAK,
SUKABUMI
IBU LILIANA/ IBU
HILDAMARKETING (0266) 7160071| (0266) 535586 Y Y Y ACTIVE ALL COVERAGE
d
830 0832 RS. HERMINA SUKABUMIJL. RAYA SUKARAJA RT.003/03,
SUKARAJA
IBU DEWI
PUJIASTUTIHUMAS 0266-6252525/6249292| 0266-235020 Y Y Y ACTIVE ALL COVERAGE
sukabumi@herminahospitalgrou
p.com
831 1107 RS. BETHA MEDIKA JL. RAYA CISAAT NO.595 SUKABUMI HANDRI/MERI MARKETING 0266-216422,224128-|- - Y Y Y ACTIVE ALL COVERAGE [email protected]
832 1507 RS. BHAKTI MEDICARE JL. RAYA SILIWANGI, CICURUGIBU MIA / PAK
RAHAYUMARKETING 0266-731555| 0266-731899 Y Y Y ACTIVE ALL COVERAGE [email protected]
SUMEDANG
833 1128 RS. PAKUWON SUMEDANGJL. RD.DEWI SARTIKA NO.17
SUMEDANG 45311BPK. ACEP
HUMAS &
PEMASARAN
0261-
210834/2797773/201132|0261-210834 Y Y Y ACTIVE ALL COVERAGE
rumahsakitumumpakuwon@yah
oo.com
834 2122 KLINIK PADJADJARAN JATINANGORJL. RAYA BANDUNG-SUMEDANG KM 21
JATINANGOR
DR. PANGESTU
WIDODO- 022-7797432 / 7781900| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
TASIKMALAYA
835 0256RSI. HJ. SITI MUNIROH
TASIKMALAYAJL. TAMAN SARI, GOBRAS, NO.208 BPK. ASEP SYAMSUL
HUMAS &
MARKETING
0265-323868,327630|0265-
3276300265-327630 Y Y Y ACTIVE ALL COVERAGE [email protected]
836 2106 APOTEK KIMIA FARMA 404JL. R.A MARTADINATA NO. 87
TASIKMALAYABPK YADI APOTEKER 0265-340515| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
837 2096 KLINIK & APOTEK KF 195JL. SUTISNA SENJAYA NO. 191
TASIKMALAYAIBU VITA - 0265-311225| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
838 1625RS. TASIK MEDIKA CITRATAMA
(TMC)JL. HZ MUSTOFA NO 310 TASIKMALAYA IBU EKA MARKETING 0265-322333| 0265-326767 Y Y Y ACTIVE ALL COVERAGE [email protected];
839 2773 RSB. SAYANG BUNDA JL. N. SUKALAYA I NO.22 IBU EUIS humas 0265330841| - Y Y Y ACTIVE ALL COVERAGE -
840 2390 RS. PRASETYA BUNDA TASIKMALAYAJL. IR. H. JUANDA NO. 1 (SIMPANG
JATI)BPK RANGGA HUMAS 0265320100/0265344477| - Y Y Y ACTIVE ALL COVERAGE [email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 31 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI841 2466 RS. PERMATA BUNDA TASIKMALAYA
JL. BRIGJEND HR. WASITA KUSUSMAH
NO.1 TASIKMALAYA, JAWA BARATIBU ELIS MARKETING 0265-345650| - Y Y Y ACTIVE ALL COVERAGE [email protected]
842 3203 RSIA. UMMI TASIKMALAYA JL. PASEH NO.10 - TASIKMALAYA IBU YANTI HUMAS 0265-329126| - Y Y Y ACTIVE ALL COVERAGE [email protected]
843 0253 RS. JASA KARTINI JL. OTTO ISKANDARDINATA NO 15IBU HENNY/ BPK
RIAMARKETING
0265-331808/3316410265-
3318641|0265-3318641
0265-
331808/331114Y Y Y ACTIVE ALL COVERAGE
[email protected]/p3ja
BANYUMAS
844 3171 RSU. WIRADADI HUSADAJL. MENTERI SUPENO NO. 25 SOKARAJA
BANYUMASIBU RINI KEUANGAN
02816846225/02816846371
|- Y Y Y ACTIVE ALL COVERAGE [email protected]
BATANG
845 3360 RS. QOLBU INSAN MULYA (QIM)JL. URIP SUMOHARDJO SAMBONG-
BATANG, JAWA TENGAHRINI - 0285-4495222| 0285-4495224 Y Y Y ACTIVE ALL COVERAGE [email protected]
BOYOLALI846 1661 RS. PKU AISYIYAH BOYOLALI JL. PASAR SAPI BARU SINGKIL IBU CHRISTINA MARKETING 0276-322898/3293400| 0726-3293400 Y Y Y ACTIVE ALL COVERAGE [email protected]
BREBES
847 2292 RS. BHAKTI ASIH BREBESJL. PANGERAN DIPONEGORO NO 125
PESANTUNAN, BREBESBPK SARTONO MARKETING 0283-673481/671279| 0283-671391 Y Y Y ACTIVE ALL COVERAGE
848 4057 RS. DERA AS-SYIFAJL. MERDEKA NO. 191, BANJARHARJO,
BREBES
BP.YONO (MKT)
087789061666- (0283) 889588| (0283) 889583 Y Y Y ACTIVE ALL COVERAGE
[email protected]/marke
BUMIAYU
849 1889 RS. MUHAMMADIYAH SITI AMINAH JL. DIPONEGORO, BUMIAYU BPK HARS. ONO - 0289-432209/430683| 0289-430683 Y Y Y ACTIVE ALL COVERAGE [email protected]
CEPU
850 1438 RS. MUHAMMADIYAH CEPU JL. RONGOLAWE, NO.137 BPK.ZAINAL/SYAM HUMAS 0296-421727|0296424678/4245
69Y Y Y ACTIVE ALL COVERAGE [email protected]
CILACAP
851 2866 RSUD. CILACAPJL. JEND GATOT SUBROTO NO. 28
CILACAPIBU ATIAH - 0282-533010| 0282-520755 Y Y Y ACTIVE ALL COVERAGE [email protected]
852 1005 KLINIK DR TUTUK JL. PERINTIS KEMERDEKAAN 21 Uun Rahayu koordinator 0282-545921-|- - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
853 2696 KLINIK & APOTEK KF 89 JL. GATOT SUBROTO NO.59, CILACAPMITHA
NOVETIANA,SF,APT- 0282 535293| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
854 4165 RS. APRILLIAJL. JEND GATOT SUBROTO NO.95
CILACAPENY WIDIASTUTI - 0282-536307| 0282-521144 Y Y Y ACTIVE ALL COVERAGE [email protected]
855 0975 RS. ISLAM FATIMAH CILACAP JL. H JUANDA NO.20 IBU ASTUTI MARKETING 0282-542396|-0282-
541065/5452151Y Y Y ACTIVE ALL COVERAGE
856 3526KLINIK PRATAMA KIMIA FARMA
CILACAPJL. GATOT SUBROTIO NO. 59 CILACAP
IBU MITHA
NOVETIANA- 0282-535293| - N Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
GOMBONG
857 1243 RS. PALANG BIRU JL. KARTINI, NO.37 IBU ANNA. S MARKETING 0287-471290/471762|0287-
473221/471762Y Y Y ACTIVE ALL COVERAGE
m
858 3327 RS. PKU MUHAMMADIYAH GOMBONG JL. YOS SUDARS. O NO.461,GOMBONGIBU PUDJI ASTUTI,
SE AKMgr Keuangan 0287-471780| - Y Y Y ACTIVE ALL COVERAGE [email protected]
JEPARA
859 3959 RSI. SULTAN HADLIRIN JEPARAJL. RAYA JEPARA BANGSRI KM 3
KUWASEN, JEPARABP. ISMAIL - (0291) 591507| (0291) 4295554 Y Y Y ACTIVE ALL COVERAGE [email protected]
860 1224 RS. GRAHA HUSADA JEPARA JL. M.H. THAMRIN, NO.14BPK.HIRMAWAN/EVI
ENDRAWATIKP.SEKRETARIAT 0291 - 592067| 0291-597806 Y N Y ACTIVE ALL COVERAGE [email protected]
KENDAL
861 1666 RSI. MUHAMMADIYAH KENDAL JL. AR RAHMAH NO 17 WELERI IBU WIWIN MARKETING0294-641870 / 0294-
643756|0294-644150 Y Y Y ACTIVE ALL COVERAGE [email protected]
KLATEN
862 0754 RS. ISLAM KLATEN JL. RAYA SOLO KM.4 DR. BERLIANTY MARKETING 0272-322252|- 0272-332422 Y Y Y ACTIVE ALL [email protected]/as
uransi_rsik@yahoo.
863 1441 RS. CAKRA HUSADA KLATEN JL. MERB. ABU, NO.7BPK.A.A.GEDE
ARMAYA-
0272-321123-322386-
322394|0272-329029 Y Y Y ACTIVE ALL COVERAGE [email protected]
864 1519RSU. PKU MUHAMMADIYAH
DELANGGUJL. DELANGGU UTARA, NO.19 IBU DINAYAH MARKETING 0272-551051| 0272-554041 Y Y Y ACTIVE ALL COVERAGE [email protected]
KUDUS
865 3259LAB. CITO (JL. AKBP AGIL
KUSUMADYA NO. 7 )JL. AKBP AGIL KUSUMADYA NO. 7 IBU VIVI - 0291-4251979| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
866 0146 RS. MARDI RAHAYU KUDUS JL. AKBP.R. AGIL KUSUMADYA, NO.110 IBU.DIAN / YATI MARKETING0291-434707-
12/435582/443581|
0291-
438398,434711Y Y Y ACTIVE ALL COVERAGE
[email protected]/mardir
MAGELANG
867 0335 RS. HARAPAN MAGELANG JL. P. SENOPATI, NO.11 IBU DESY / IBU LILIMARKETING/CUST.
SERS0293-364033-35| 0293-364036-37 Y Y Y ACTIVE ALL COVERAGE
868 1132 RS. LESTARI RAHARJA JL. MAYJEN SUTOPO NO.5 BPK.JUPRI SEKRETARIAT 0293-362225|0293-
362649/311512Y Y Y ACTIVE ALL COVERAGE [email protected]
JAWA TENGAH
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 32 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI869 3286 LAB. CITO MAGELANG
JL. TENTARA PELAJAR NO 126
MAGELANG
BPK DONI EKO
NURMAWAN- 0293 363763| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PATI
870 1299 KELUARGA SEHAT HOSPITAL JL. P.SUDIRMAN NO.9 MARGOREJOIBU NURI DHARS.
ANTIMARKETING 0295-386111| 0295-384422 Y Y Y ACTIVE ALL COVERAGE [email protected]
871 1534 RS. MITRA BANGSA JL. KOL.SUGIYONO, NO.75 BPK. LILIK/IBU YANI MARKETING 0295-382555| 0295-4191994 Y Y Y ACTIVE ALL [email protected];
PEKALONGAN
872 0120 RS. SITI KHODIJAH PEKALONGAN JL. BANDUNG, NO.39-47 DR. IRVINA MARKETING
0285-
422845,425138,423590,424
919|
0285-425138 Y Y Y ACTIVE ALL [email protected]/rssk_pkl
@telkom.net
873 3227 LAB. CITO PEKALONGAN JL. K.H. MANSYUR NO.33 PEKALONGANYENI ERI
KRISNAWATIKEPALA CABANG 0285-422458| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
874 2694 KLINIK & APOTEK KF 16JL. IMAM BONJOL, NO.16 A,
PEKALONGAN
DRS. ANIS SALIM,
APT- 0285 421402| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
875 3186 RSIA. ANUGERAH PEKALONGANJL. PERINTIS KEMERDEKAAN NO. 3,
KRAMAT SARI, PEKALONGAN 51118LULUK Marketing 0285-431491| (0285) 431903 Y Y Y ACTIVE ALL COVERAGE [email protected]
876 1220 RS. BUDI RAHAYU PEKALONGAN JL. BARITO, NO.5 PEKALONGAN IBU. ENIMARKETING/KEUA
NGAN0285 - 423491/424340| 0285-423002 Y Y Y ACTIVE ALL COVERAGE
PEMALANG
877 4093 RS. PRIMA MEDIKA PEMALANGJL. SLAMET RIYADI NO. 321
MULYOHARJO, PEMALANGIBU ROSI AMINAH MARKETING 021-5396737| - Y Y Y ACTIVE ALL COVERAGE [email protected]
878 1219 RSU. SANTA MARIA PEMALANG JL. PEMUDA NO.24IBU JEMI PUJI
ASTUTIMARKETING 0284 - 321251/321426| 0284 - 322335 Y Y Y ACTIVE ALL COVERAGE
marketing_santamariapml@yaho
o.co.id
PURBALINGGA
879 1888 RSU. HARAPAN IBU PURBALINGGA JL. MAYJEND SOENGKONO NO. 1 BPK HARI MARKETING 0281-892222/982277| - Y Y Y ACTIVE ALL COVERAGE [email protected]
PURWODADI
880 1226 RS. PANTI RAHAYU JL. LETJEND. SUPRAPTO NO.6BPK.SARYOTO
(YOYOK)MARKETING 0292 - 421087-422325|
0292-
421370/425095Y Y Y ACTIVE ALL COVERAGE
[email protected];kilo
PURWOKERTO
881 1448 RSIA. BUNDA ARIF PURWOKERTOJL. JATIWINANGUN, NO.16
PURWOKERTO
DR EMAN/ BPK
NANAHUMAS 0281-636555| - Y Y Y ACTIVE ALL COVERAGE [email protected]
882 0825 RS. ST. ELISABETH - PURWOKERTO JL. DR ANGKA NO 40, PURWOKERTO
IBU
SEPTI/DR.ASTHER
PRIMANDARI
TATA USAHA
0281-
627384/632833/623117/62
58570281-635278|0281-
635278
(0281) 640005 Y Y Y ACTIVE ALL COVERAGE [email protected]
883 0201 RSU. BUNDA PURWOKERTO JL. PRAMUKA, NO.249 UUT / DR.TATI MARKETING0281-6354240281-
632514|0281-6325140281-632514 Y Y Y ACTIVE ALL COVERAGE
884 2095 KLINIK & APOTEK KF FAJAR SEHATJL. R.A WIRIATMAJA NO. 37
PURWOKERTO
IBU ANTON
WIYANTI- 0281-637247| 0281-640760 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
885 2094APOTEK KIMIA FARMA 133
PURWOKERTO
JL. JEND. SUDIRMAN TIMUR NO. 435
PURWOKERTOBPK. AGUS Apoteker 0281-638546| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
886 1447 RSU. ANANDA PURWOKERTO JL. PEMUDA, NO.30 IBU DESI/YOKE MARKETING 0281-631435-636417|0281-
640226/632146Y Y Y ACTIVE ALL COVERAGE
[email protected]/yoke@rs
ananda.co.id
887 1351 RS. ORTHOPAEDI PURWOKERTOJL. SOEPARDJO ROESTAM NO. 99
PURWOKERTOBPK HERU - 0281-6844166| 0281-6844188 Y Y Y ACTIVE ALL COVERAGE [email protected]
888 3131 LAB. CITO PURWOKERTO JL. PRAMUKA 798 RT 7/1 PURWOKERTO BPK SINGGIH MARKETING 0281-637362; 637538| 0281-637583 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PURWOREJO
889 1908 RS. PALANG BIRU KUTOARJOJL. MADITOMO 17, KUTOARJO-
PURWOREJOIBU MIA SEKERTARIAT 0275-641425| - Y Y Y ACTIVE ALL COVERAGE [email protected]
890 1131RS. PKU MUHAMMADIYAH
PURWOREJO
JL. BRIGJEND KATAMSO NO.144 A
PURWOREJO
BPK ARIF
MUSTAWANMARKETING 0275-325260| 0275-324211 Y N Y ACTIVE ALL COVERAGE [email protected]
SALATIGA
891 1145 RS. PURI ASIHJL. JEND. SUDIRMAN NO.169
SALATIGA
IBU NURUL/IBU TRI
HANDAYANIMARKETING 0298-323209/0298-312049|
0298-
322898/311466Y Y Y ACTIVE ALL COVERAGE
[email protected];rs_purias
892 3350 APOTEK KIMIA FARMA SALATIGAJL. BRIGJEN SUDIARTO NO. 30
SALATIGAPAK MULYADI - 0298-325350| - N Y Y ACTIVE ALL COVERAGE [email protected]
SEMARANG
893 3349 APOTEK KIMIA FARMA 203 UNGARAN JL. DIPENOGORO 212 UNGARAN PAK MULYADI - 024-76914353| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
894 3245LAB. CITO (JL. INDRAPRASTA NO. 81
A)JL. INDRAPRASTA NO. 81 A SEMARANG BP RIZKY - 024-3556853| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
895 3246 LAB. CITO ( JL. SETIABUDI ) JL. SETIABUDI SEMARANG BPK HERY - 024-7461645| N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
cito_setiabudi@yahoo
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 33 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI896 3247 LAB. CITO ( JL. DR. CIPTO ) JL. DR. CIPTO 14A SEMARANG IBU ROSALIA - 024-3515374| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
897 2168 APOTEK FARMARIN SEMARANG JL. KALIGARANG NO. 2DWIWIN YUWINDARI,
S.SI, APTAPOTEKER 024-8450558| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
898 1450 RS. PERMATA MEDIKAJL. MR.MOCH. ICHSAN, NO.93-97,
NGALIYAN
IBU BUDI/IBU ERNI
WIDYANINGRUM
HUMAS &
MARKETING
024-
7625005/7618800/7626571
|
024-7621733 Y Y Y ACTIVE ALL [email protected];widyani
899 2692 KIMIA FARMA 178JL. BRIG.SUDIARTO,462 E (MAJAPAHIT
LAMA)
DESI RAHMAWATI,
S.FARM, APT024 6716235| -- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
900 2693 KLINIK & APOTEK KF 71 JL. DR.SOETOMO NO.3 , SEMARANGHERU SUDOMO,
S.FAR, APT- 024 3520763| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
901 0160 RS. ST. ELISABETH - SEMARANG JL. KAWI NO. 1 IBU TARI/EKAMARKETING/HUMA
S024-8310076/ 8310035| 024-8413373 Y Y Y ACTIVE ALL COVERAGE [email protected]
902 0377 RS. TELOGOREJO JL. KH. AHMAD DAHLAN IBU ANI MARKETING024 - 8446000/8448448024-
8446000|024-8446000024 - 8449660 Y Y Y ACTIVE ALL COVERAGE [email protected]
903 1663 RS. KEN SARAS JL. SOEKARNO HATTA KM 029 IBU CACA MARKETING 024-6922269| 0298-522706 Y Y Y ACTIVE ALL COVERAGE [email protected]
904 0053 RS. ROEMANI MUHAMMADIYAH JL. WONDRI, NO.22BPK. AGUNG
JATMIKOCS / PENAGIHAN 024 - 8444623| 024-8415752 Y Y Y ACTIVE ALL COVERAGE
905 0379 RS. PANTI WILASA CITARUM JL. CITARUM, NO. 98DRG.CRISWIDYATI /
BPK.KIKIMARKETING
024-3542224 /
081228345674 ( BPK KIKI )|
024-
3561514,3542063Y Y Y ACTIVE ALL COVERAGE
marketing.pantiwilasa.citarum@
gmail.com
906 0050 RS. PANTI WILASA DR. CIPTO JL. DR. CIPTO, NO.50 BPK. BAYU MARKETING 024 - 3546040, 3557428| 024-3546042 Y Y Y ACTIVE ALL [email protected].
net.id
907 0299RSU. HERMINA PANDANARAN
SEMARANGJL. PANDANARAN NO.24 IBU ENO
HUMAS &
MARKETING024-8411112/8442525| 024-8450818 Y Y Y ACTIVE ALL COVERAGE
pandanaran@herminahospitalgro
up.com
908 0182 RS. ISLAM SULTAN AGUNG JL. KALIGAWE KM.4 IBU. SRI WAHYUNI MARKETING 024-6580019| 024-6581928 Y Y Y ACTIVE ALL [email protected];rsisula
@indosat.net.id
909 0901 RS. BANYUMANIK JL. BINA REMAJA NO.61 BPK SOBIRIN MARKETING024-7471519024-
7462181|024-7462181024-7462181 Y Y Y ACTIVE ALL COVERAGE [email protected]
910 3260KIMIA FARMA 19 (JL. SULTAN
AGUNG)
JL. SULTAN AGUNG KOMPL.
PERTOKOAN R A/15 SEMARANG
RICKY FABIANO
AMRI- 024-8315248| 024-8315795 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
911 3261KIMIA FARMA 153 (JL. JATI RAYA
BANYUMANIK)
JL. JATI RAYA BANYUMANIK,
SEMARANG
LINTANG
ANTYANING / DITHA
DWIKE
- 024-7464268| 024-7464268 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
912 3262 KIMIA FARMA 259 (JL. FATMAWATI) JL. FATMAWATI NO. 42, SEMARANG SHINTA DEWI Penanggungjawab 024-76928544| 024-76928544 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
913 3264KIMIA FARMA 271 MEDITAMA (JL.
AHMAD)
JL. KH. AHMAD DAHLAN NO. 9, KEL.
BENDUNGAN, KEC. GAJAHMUNGKURMEGA RESTU - 024-8455323| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
914 3265KLINIK & APOTEK 324 (JL. RAYA
NGALIAN)
JL. RAYA NGALIYAN , KEL. TAMBAK AJI,
KEC.NGALIYAN SEMARANG
DAVID ARISANDI
ATMADJI- 024-7612049| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
915 3267 KIMIA FARMA 374 (JL. TELOGO SARI)
JL. TLOGOSARI RAYA NO. 1 KAV. 2,
KEL. TLOGOSARI KULON, KEC.
PEDURUNGAN, SEMARANG
INTAN IRDA MELATI - 024-6709192| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
916 3215 RS. WILLIAM BOOTH SEMARANG JL. S. PARMAN NO. 5 SEMARANG IBU AGNES MARKETING 024-8411800| Y Y Y ACTIVE ALL COVERAGE [email protected]
917 2246 APOTEK KIMIA FARMA 17JL. TENTARA PELAJAR NO. 16 A,
SEMARANGBP RUSTIONO - 024-8447245| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
918 2238 KLINIK & APOTEK KF 18 JL. PEMUDA NO. 135 SEMARANG BPK RUSTINO -
024-
3545101/3541510/3518913
|
- N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
919 2822 RS. COLUMBIA ASIA SEMARANG JL. SILIWANGI NO. 143 SEMARANGINDAH W.G
(081901616318)Marketing (024) 762 9999/86462020| (024) 7667 4228 Y Y Y ACTIVE ALL COVERAGE
m
920 3217 KLINIK KITA TEMBALANG (DR MOEZ)JL. NGESREP TIMUR 5/36
BANYUMANIK, SEMARANGNURYATI - 085640398938| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
921 3218 KLINIK KITA KALIPANCUR (DR MOEZ)JL. ABDULRAHMAN SALEH KAV. 783
KALIPANCUR, SEMARANGDESITA - 085641869731| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
922 2969 RS. HERMINA BANYUMANIK
JL. JENDRAL POLISI ANTON
SOEDJARWO NO. 195 A, SEMARANG
50263
IBU DINDA/ IBU
TARIMARKETING (024) 7648 8989| (024) 7647 9080 Y Y Y ACTIVE ALL COVERAGE
banyumanik@herminahospitalgr
oup.com
923 3230KLINIK KITA KEDUNGMUNDU (DR
MOEZ)
JL. KEDUNGMUNDU RUKO GRAHA
WAHID NO. 7, SEMARANG- - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
924 3231KLINIK KITA IBNU SIENA
PUSPONJOLO (DR MOEZ)
JL. PUSPONJOLO TENGAH RAYA NO.
65, SEMARANG- - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
925 3232KLINIK KITA IBNU SIENA NGALIYAN
(DR MOEZ)
JL. PROF HAMKA RUKO SEGITIGA
EMAS B 7, SEMARANG- - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 34 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI926 3233 KLINIK KITA CANGKIRAN (DR MOEZ)
JL. JATI KALANGAN RUKO PURI DELTA
ASRI, SEMARANG- - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
SLAWI
927 1665 RS. ADELLA JL. PROF MOH YAMIN NO. 77 SLAWI IBU NINA/LESTI MARKETING 0283-491154/491773| 0283-491354 Y Y Y ACTIVE ALL COVERAGE [email protected]
SOLO
928 2181 APOTEK FARMARIN SOLO JL. GREMET NO.3 RT 007/11 MANAHANFITRIA WULANDARI,
S.SI, APT- 085727427423| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
929 0118 RS. DR. OEN SOLO BARUKOMP. PERUMAHAN SOLO BARU,
GROGOL, SUKOHARJO
IBU LILA/ IBU ANI
/BPK MULYADIMARKETING 0271-620220|
0271-
622555/660935Y Y Y ACTIVE ALL COVERAGE
930 1483 RS. PANTI WALUYO SURAKARTA JL. JEND.A.YANI NO.1 IBU ADELIA MARKETING 0271-712077| 0271-729125 Y Y Y ACTIVE ALL [email protected];rspa
931 0119 RSU. KASIH IBU SURAKARTA JL. BRIGJEND SLAMET RIYADI NO.404DRG. HARIANI/IBU
YOVITAMARKETING 0271 - 714422| 0271-722837 Y Y Y ACTIVE ALL COVERAGE
[email protected]/rsuk
932 0212 RS. ISLAM KUSTATI JL. KAPTEN MULYADI NO.249IBU.JAZARIA/BPK
TOTO
INFORMASI/SEKRE
TARIA0271 - 643013| 0271-634823 Y Y Y ACTIVE ALL COVERAGE [email protected]
933 0214RS. DR. OEN SURAKARTA(KANDANG
SAPI)
JL. BRIGJEN KATAMSO NO.55,
KANDANG SAPIDR. SUSILOWATI MARKETING 0271-643139| 0271-642026 Y Y Y ACTIVE ALL COVERAGE [email protected]
934 0745 RS. ISLAM SURAKARTAJL. A YANI PABELAN KARTASURA,
SOLO
BPK.KHOLID/ IBU
FATAHMARKETING
0271-7105710271-
725134|0271-7251340271-710572 Y Y Y ACTIVE ALL COVERAGE
[email protected];info@rsisy
arsis.com
935 0746 RS. PKU MUHAMMADIYAH SOLO JL. RONGGOWARSI. TO NO130, SOLO IBU BETTY HUMAS 0271-714578| 0271-717012 Y Y Y ACTIVE ALL COVERAGE [email protected]
936 1179 RS. BRAYAT MINULYA JL. DR.SETIABUDI NO.106 SURAKARTA IBU GITA / RIA Marketing0271-
716646,710571,710170|
0271-
727309/712181Y Y Y ACTIVE ALL COVERAGE [email protected]
937 3280LAB. KLINIK KIMIA FARMA
SURAKARTAJL. ADISUCIPTO NO. 70 SURAKARTA - - 0271-727886| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
938 3279 LAB. CITO SOLO JL. YOSODIPURO NO.64 SURAKARTA ANDREAS DWI - 0271-2500055| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
939 1180 KLINIK BUDI SEHAT JL. S.PARMAN, NO.131, PASAR LEGIIBU
PRASETYANINGSIHMARKETING 0271-648026-661415|
0271-
643265/661366N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
940 2907 RS. HERMINA SOLO JL. KOL SUTARTO NO. 16 JEBRES SOLO DRG DYAH MARKETING 0271-638989| 271 Y Y Y ACTIVE ALL COVERAGE [email protected]
941 3354 APOTEK KIMIA FARMA YOSODIPURO JL. NO.111B, SOLO - - -| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
SRAGEN945 1660 RS. SARILA HUSADA JL. VETERAN NO 41-43 SRAGEN BP TULUS PERSONALIA 0271-891538| Y Y Y ACTIVE ALL COVERAGE -
946 3353 APOTEK KIMIA FARMA SRAGEN JL. SUKOWATI NO.440A, SRAGEN - - -| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
SUKOHARJO
947 3355 APOTEK KIMIA FARMA SUKOHARJO JL. VETERAN NO.11 SUKOHARJO - - 0271-590411| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
948 1178 RS. NIRMALA SURI JL. RAYA SOLO KM 9 SUKOHARJO BP. ARIFIN MARKETING 0271-592192| - Y Y Y ACTIVE ALL COVERAGE [email protected]
TEGAL949 3359 RSIA. PALARAYA JL. PALARAYA NO. 11 A TEGAL BAPAK PRANATA -- 0283-356009| - Y Y Y ACTIVE ALL COVERAGE [email protected]
950 2093 APOTEK KIMIA FARMA 97 TEGAL JL. MAYJEN SUTOYO NO. 44 TEGAL BPK TEGUH - 0283-354733/355765| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
951 0753 RS. ISLAM HARAPAN ANDA JL. ABABIL NO.42 IBU. NURUL MARKETING 0283-358244| 0283-351263 Y Y Y ACTIVE ALL [email protected]/nurul@h
arapananda.com
952 1540 RS. MITRA KELUARGA TEGALJL. SIPELEM, NO.4, KEMANDUNGAN,
TEGAL BARATDR.SERLY/IBU TINA MARKETING 0283-340399/340999| 0283-340902 Y Y Y ACTIVE ALL COVERAGE
953 3220 LAB. CITO TEGAL JL. GAJAH MADA NO. 79 TEGAL SILVIA AYU - 0283 353402| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
954 1873 RS. MITRA SIAGA TEGAL JL. PALARAYA NO. 54 TEGAL TRI NURCAHYO KA. HUMAS 0283-353387/322550| 0283-351518 Y Y Y ACTIVE ALL COVERAGE [email protected]
TEMANGGUNG
955 1144 RS. NGESTI WALUYO JL. PAHLAWAN-PARAKANBPK.KRISYATNO/BP
K.WISTOMO
HUMAS
MARKETING0293-596008| 0293-596410 Y Y Y ACTIVE ALL COVERAGE [email protected]
WONOGIRIWONOSOBO
BANGIL
956 0700 RS. ISLAM MASYITHOH JL. A. YANI, NO.6IBU ERMA
ZUBAEDAHMARKETING 0343-741018| 0343-742425 Y Y Y ACTIVE ALL COVERAGE [email protected]
BANGKALAN
JAWA TIMUR
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 35 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI957 3841
APOTEK KIMIA FARMA TRUNOJOYO
419JL. TRUNOJOYO NO.75A BANGKALAN
DIAN
LARASATI.S.FARM- 0313095459| 313095459 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
958 3840 APOTEK KIMIA FARMA 163 JL. JOKOTOLE NO.5 BANGKALANLAKSMI
KUSUMASTUTI- 0313091016| 313091016 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
959 3595 RS. LUKAS JL. KH.MOH.KHOLIL 36ADR.ARTO
085235779518;MARKETING 031-3095148| - N Y Y ACTIVE ALL COVERAGE
artok_wijayanto@yahoo
BANYUWANGI
960 4065RS. NAHDLATUL ULAMA
BANYUWANGI
JL. RAYA MANGIR NO. 09 KEC.
ROGOJAMPI KAB. BANYUWANGIAGUS BAIDLAWI - 0333-632965| 0333-632965 Y Y Y ACTIVE ALL COVERAGE [email protected]
961 4130RSIA. PKU MUHAMMADIYAH
ROGOJAMPI
JL. PANGERAN DIPONEGORO NO. 20,
ROGOJAMPIPUTRI TRIANASARI MARKETING 0333-631149| - Y Y Y ACTIVE ALL COVERAGE [email protected]
962 0726 RS. ISLAM FATIMAH BANYUWANGI JL. JEMBER, NO.25FANI / BPK.AINUR
RAFIQ
personalia/MARKET
ING0333-421451|
0333-
423204/417929Y Y Y ACTIVE ALL COVERAGE
[email protected],iqbwi@ya
hoo.com
963 1429 RS. YASMIN BANYUWANGI JL. LETKOL ISTIQLAL NO.80-84 BP. AGUS HUMAS 0333-424671| -0333-418219 Y Y Y ACTIVE ALL COVERAGE [email protected]
964 0724 RS. AL-HUDA JL. DIPONEGORO, NO.65, GENTENG IBU LISA/IBU PRIMA MARKETING
0333-
842033/844682/845248/84
2118|
0333-842036/38 Y Y Y ACTIVE ALL COVERAGE [email protected]
BLITAR
965 0269 RS. KATOLIK BUDI RAHAYU BLITAR JL. JEND. A.YANI NO. 18 BLITARBP.YOSEP/IBU
RITA/IBU KALISTAMARKETING
0342-
801066/802316/807802|
0342-
806509/804284Y Y Y ACTIVE ALL COVERAGE [email protected]
966 3807 RS. UMUM AMINAH BLITARJL. VETERAN NO. 39, KEPANJEN, KIDUL
BLITAR 66111IBU EMI MARKETING 0342-816304/816305| 0342-816527 Y Y Y ACTIVE ALL COVERAGE [email protected]
BOJONEGORO
967 1032 RS. PKU MUHAMMADIYAH KALITIDU JL. RAYA KALITIDU, NO.266, KALITIDU NURHADI MARKETING 0353-511731/512066-|-0353-
511678/512066Y Y Y ACTIVE ALL COVERAGE
rsmuhammadiyahkalitidu@gmail
.com968 0731 RS. AISYIYAH BOJONEGORO JL. HASHIM ASHAARI, NO.17 IBU INDAH MARKETING 0353-881748/885978| 0353-885978 Y Y Y ACTIVE ALL COVERAGE [email protected]
BONDOWOSO
969 3892 RS. MITRA MEDIKA BONDOWOSOJL. HOS COKROAMINOTO 98,
BONDOWOSOIFAN RIZKY marketing 0332-423800; 421981| 0332 429601 Y Y Y ACTIVE ALL COVERAGE
customerservice@rsmitramedika
.com
GRESIK
970 3648 RSUD. IBNU SINA KAB. GRESIK JL. DR. WAHIDIN SH NO.243B, GRESIK -DR. SRI RAHAYU Humas 031-3951239| - Y N Y ACTIVE ALL COVERAGErsudibnusina.marketing@yahoo.
com
971 4235 RS. FATHMA MEDIKA GRESIKJL. PENDOPO NO. 45, SEMBAYAT,
MANYAR, GRESIK
IBU DESI
RAHMAT/PAK SETYO- (031) 394 3500| - Y Y Y ACTIVE ALL COVERAGE [email protected]
972 4053 RS. PETROKIMIA GRESIK DRIYOREJO JL. RAYA LEGUNDI KM 5 NEVIA -031-8986701, 8981779,
8981778|031-8986700 Y Y Y ACTIVE ALL COVERAGE [email protected]
973 0596 RS. SEMEN GRESIK JL. RA. KARTINI, NO.280 GRESIK IBU. IRIA MARKETING031 -
3987840,3989478,3975847|031-3987842 Y Y Y ACTIVE ALL COVERAGE
974 1923RS. PETROKIMIA GRESIK GRHA
HUSADA
JL. PADI NO. 3 KOMPLEK PT
PETROKIMIA GRESIKBPK REZA -
031-
3984465,3973400,3793401|031-3972623 Y Y Y ACTIVE ALL COVERAGE [email protected]
975 2610 RS. WATES HUSADA
JL. RAYA WATES UTARA
KEDUNGPRING, BALONGPANGGGANG -
GRESIK
PUJIHARTO
(031)77109257- (031) 7922351| - Y Y Y ACTIVE ALL COVERAGE [email protected]
976 3842 APOTEK KIMIA FARMA 164 JL. R.A KARTINI NO.150-152 ADNAN AZHARY - 0313984783| 313984783 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
977 1427 RS. PETROKIMIA GRESIK JL. JEND. A.YANI NO.69
IBU
MEKA/DR.RETNO/IB
U SITI
MARKETING
031-
3988877/3990994/3978658
/3977666|
031-
3980008/3981232Y Y Y ACTIVE ALL COVERAGE
[email protected]/rspg2004
@yahoo.co.id
JEMBER
978 1428 RS. BINA SEHAT JL. JAYANEGARA NO.7 BP. NICO HUMAS0331-
422701/424304/421713|0331-428390 Y Y Y ACTIVE ALL COVERAGE [email protected]
979 2076 KLINIK & APOTEK KF 62 JEMBER JL. GAJAH MADA 171 JEMBER AYU APOTEKER 0331-489020| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
980 1685RSU. KALIWATES PT PERKEBUNAN
NUSANTARA XIIJL. DIAH PITALOKA NO 1 JEMBER BP MAHMUD HUDA Marketing 0331-3137525/483567| 0331-489100 Y Y Y ACTIVE ALL COVERAGE
981 0725 RS. PERKEBUNAN (PTPN) X JEMBER JL. BEDADUNG, NO.2 JEMBERBPK. FEBRI/ IBU
SANTIMARKETING
0331-
487104,485415,426873,485
912,4107480331-
487226|0331-487226
0331-485912 Y Y Y ACTIVE ALL COVERAGE [email protected]
982 3530 RS. CITRA HUSADA JL. TERATAI NO.22 JEMBER IBU RATIH MARKETING (0331) 486200| (0331) 427088 Y Y Y ACTIVE ALL COVERAGE rs_citrahusada@ya
983 2077 APOTEK KIMIA FARMA 241 JEMBERJL. PANGLIMA SUDIRMAN NO. 46
JEMBERHIMAWAN - 0331-489885| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
JOMBANG
984 1849 RSIA. MUSLIMAT JOMBANG JL. URIP SUMOHARJO NO 34 JOMBANG
IBU RJ EKA
RAHMANDA /BPK
RISHI
HUMAS&MARKETIN
G
0321-
872200/877600/869434|0321-854991 Y Y Y ACTIVE ALL COVERAGE
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 36 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI985 0810 RS. DR. MOEDJITO DWIDJOSISWOJO JL. HAYAM WURUK, NO.9 JOMBANG
IBU ERI/ QORI
RAMEANMARKETING
0321-
864308,6977788,855555|0321-877276 Y Y Y ACTIVE ALL COVERAGE
[email protected]/hospit
986 1880 RS. AIRLANGGA JOMBANGJL. AIRLANGGA NO 50 C JELAKOMBO,
JOMBANGIBU DEVI MARKETING 0321-861577| 0321-862194 Y Y Y ACTIVE ALL COVERAGE [email protected]
987 0978 RS. KRISTEN MOJOWARNO JL. MERDEKA NO.59, MOJOWARNO IBU EVI MARKETING 0321-495093-|-0321-
492200/495440Y Y Y ACTIVE ALL COVERAGE
988 1966 RS. PELENGKAP MEDICAL CENTER JL. JUANDA NO. 03 JOMBANGBPK KUSWOYO/ IBU
CINTYAMARKETING 0321-877945 / 869826| - Y Y Y ACTIVE ALL COVERAGE [email protected]
KEDIRI
989 1998 KLINIK & APOTEK KF 75 KEDIRIJL. JAKSA AGUNG SUPRAPTO NO. 25
KEDIRIFAIZ APOTEKER 0354-773384/ 694913| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
990 1599RS. MUHAMMADIYAH AHMAD
DAHLAN KEDIRIJL. GATOT SUBROTO NO 84 KEDIRI
IBU SITI NASYATUL
AISIAHPEMASARAN
0354-
773115/776182/770182|
0354-
776318/773736Y Y Y ACTIVE ALL COVERAGE [email protected]
991 0977 RS. BAPTIS KEDIRI JL. BRIDJEN POLLBH PRANOTO NO.1WAHYU WASITO
WIBOWOMARKETING
0354-682170, 683578,
684172-|-0354-681173 Y Y Y ACTIVE ALL COVERAGE [email protected]
992 0248 RS. HVA TOELOENGREDJO JL. A. YANI NO. 25 PARE
DRG
MENIS/YANNEKE/W
AHYU JAYADI
MARKETING 0354-391047,391145| 0354-392883 Y Y Y ACTIVE ALL [email protected]/rstoel_it@ya
hoo.co.id
993 2075 APOTEK KIMIA FARMA 151 KEDIRI JL. STASIUN NO. 47 KEDIRI TULUS APOTEKER 0354-694913| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
994 1430 RS. AURA SYIFA JL. JOYOBOYO NO.42 DLOPODR. BENY CAHYO/
IBU YULIMARKETING 0354-671939|
0354-
696033/641939Y Y Y ACTIVE ALL COVERAGE [email protected]
995 1182 RS. BHAYANGKARA KEDIRI JL. KOMBES POL DURYAT NO 17 IBU EMI MARKETING 0354-671100| 0354-683830 Y Y Y ACTIVE ALL COVERAGE [email protected]
996 3828 APOTEK KIMIA FARMA SMAN II PAREJL. PAHLAWAN KUSUMA BANGSA 28
PAREBP. WAHYU APOTEKER 0354-390006| 0354-390006 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
LAMONGAN
997 1199 RS. MUHAMMADIYAH LAMONGAN JL. JAKSA AGUNG SUPRAPTOIBU
NOVI/BPK.ZUHDIMARKETING 0322-322834| 0322-314048 Y Y Y ACTIVE ALL COVERAGE [email protected]
LUMAJANG
998 1247 RS. WIJAYA KUSUMA JL. A. YANI, NO.149, LUMAJANG IBU SENJA/ERNASEKRETARIAT/KEU
ANGAN0334-891325| 0334-888844 Y Y Y ACTIVE ALL COVERAGE [email protected]
MADIUN999 1183 RS. SITI AISYAH JL. MAYJEN SUNGKONO, NO.38 SUNARTO Marketing 0351-464822/451843| 0351-464009 Y Y Y ACTIVE ALL COVERAGE [email protected]
1000 3425 KLINIK & APOTEK KF 76 JL. JAWA NO.14 BPK.BAMBANGPENANGGUNG
JAWAB035-453381| 0351-453381 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1001 0722 RS. SANTA CLARA JL. BILITON, NO.15 SUSTER YOSSIE HUMAS0351-
462688/452770/464571|
0351-
455780/466509Y Y Y ACTIVE ALL COVERAGE
[email protected]/pantib
MADURA
1002 0113 RS. LARASATI JL. MANDILARAS, NO.74, PAMEKASAN IBU LISAMARKETING/PEL.M
EDIS0324-328305| 0324-322080 Y Y Y ACTIVE ALL COVERAGE [email protected]
MALANG
1003 0815 RS. PANTI WALUYA SAWAHAN JL. NUSAKAMBANGAN NO.5 IBU RUSMAWATIHUMAS &
MARKETING
0341-
362017,366033,361507|0341-354068 Y Y Y ACTIVE ALL COVERAGE
1004 0125 RSIA. MELATI HUSADA JL. KAWI, NO.32 IBU YATI MARKETING0341-336271/3413570341-
341357|0341-341357
0341-
365094/341357Y Y Y ACTIVE ALL COVERAGE [email protected]
1005 0708 RS. LAVALETTE JL. W.R. SUPRATMAN, NO.10IBU NUNU
WARDANI/ WINAMARKETING 0341-470805/482612| 0341-470804 Y Y Y ACTIVE ALL COVERAGE [email protected]
1006 4172RSU UNIVERSITAS MUHAMMADIYAH
MALANGJL. TLOGOMAS NO. 45 MALANG LIDYA - 0341 56166| 0341 561627 Y Y Y ACTIVE ALL COVERAGE
[email protected];marketingrs
1007 3611 RSI. MADINAH KASEMBONJL. RAYA SUKOSARI NO. 32 KASEMBON
MALANG
DR
TAUFIKURRAHMAN- 0354-326688/ 393000| 0354-328144 Y Y Y ACTIVE ALL COVERAGE [email protected]
1008 3620 APOTIK KIMIA FARMA 77JL. SUKARJO WIRYOPRANOTO 2K
MALANGMuamar - 0341-365298| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1009 0192 RS. BAPTIS BATUJL. RAYA TLEKUNG NO.1 JUNREJO,
BATU
DRG. SILVIA
DINA/IBU
WIDYA/FRANSISKA/
WIWIN
HUMAS &
MARKETING
0341-5941610341-
598192/5|0341-598192/50341-598911 Y Y Y ACTIVE ALL COVERAGE [email protected]
1010 3437 RSB. MARDI WALOEJA RAMPAL JL. WR. SUPRATMAN NO.01 MALANGINDRA DWI
MISKAWATI- (0341) 364756| - Y Y Y ACTIVE ALL COVERAGE
rsb.mardiwaloeja.rampal@gmail.
com
1011 2967 PERSADA HOSPITALJL. PANJI SUROSO ARAYA BUSINESS
CENTER KAV.II-IV MALANGBPK DIKA/ YOGA - 0341-2996333| 0341-2993773 Y Y Y ACTIVE ALL COVERAGE [email protected]
1012 3814 KIMIA FARMA 453 SUTOYO MALANG JL. LETJEN SUTOYO NO. 107 MALANG - - 0341478382| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 37 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1013 3815 KIMIA FARMA NO.245 BATU
JL. DIPONEGORO NO. 93 BATU
MALANG- - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1014 3816 KIMIA FARMA NO. 210 MALANGJL. TUMENGGUNG SURYO NO. 25
MALANG- - 0341423930| - N Y Y PARTIAL
GP,SP,OP,MAT,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1015 3817 KIMIA FARMA NO. 187 MALANG JL. M.T. HARYONO NO. 110 MALANG - - 0341553283| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1016 3818 KIMIA FARMA NO. 150 MALANG JL. SELAT SUNDA 1 D NO. 25 MALANG - - 0341713091| - N Y Y PARTIALGP,SP,OP,MAT,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1017 3820 KIMIA FARMA NO. 36 MALANG JL. IJEN NO. 88 MALANG ANDY ISWANTORO - 0341359677| 341359678 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1018 2048 RS. PRIMA HUSADA MALANGJL. BANJARARUM SELATAN NO. 3,
MONDOROKO SINGOSARI-MALANG
MADE DEWA
SANTIKA
MANAGER
OPERASIONAL0341-458679| 0341-441874 Y Y Y ACTIVE ALL COVERAGE [email protected]
1019 2171 APOTEK FARMARIN MALANGJL. W. R.SUPRATMAN C2 KAV.9
MALANG
YUDI PURNOMO, S.
SI, APTAPOTEKER 0341-334163/4| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1020 2274 KLINIK & APOTEK KF 53 JL. KAWI NO.22 A MALANG ANDY ISWANTONO - 0341 362 301/ 364 056| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1021 2790 RSIA. GALERI CANDRAJL. BUNGA ANDONG NO.3 MALANG
65141
IRMAWATI (081
3335 20478)- (0341) 478571| (0341) 478571 Y Y Y ACTIVE ALL COVERAGE [email protected]
1022 2680 KIMIA FARMA 116 JL. LA SUCIPTO /148,MALANGRATNO SETIAWAN S
FARM- 0341-489539| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1023 2789 RSIA. PURI MALANG JL. TAMAN SLAMET NO.20 MALANG SETIAWATI/IFA UMUM 0341-325329| (0341) 342322 Y Y Y ACTIVE ALL COVERAGE [email protected]
1024 4089 RS. ISLAM GONDANGLEGIJL. HAYAM WURUK NO 66,
GONDANGLEGIWIDI MARKETING 0341 - 879047| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1025 1326 RS. WAVA HUSADA KEPANJENJL. PANGLIMA SUDIRMAN NO.99A
KEPANJENIBU YAYUK MARKETING 0341-393000| 0341-398398 Y Y Y ACTIVE ALL COVERAGE
1026 1561 RS. PERMATA BUNDA MALANGJL. SOEKARNO HATTA NO. 75,
LOWOKWARUIBU ICHA MARKETING 0341-487487/407462| 0341-474242 Y Y Y ACTIVE ALL COVERAGE [email protected]
1027 0609 RS. PANTI NIRMALA JL. KEBALEN WETAN, NO.2-8IBU ITA/ DR.
CECILLIAMARKETING 0341-362459| 0341-327930 Y Y Y ACTIVE ALL COVERAGE
[email protected];rahmaemai
1028 1325 RS. MARSUDI WALUYOJL. RAYA MONDOROKO KM.9
SINGOSARIDR. ANITA MARKETING 0341-458974| 0341-451579 Y Y Y ACTIVE ALL COVERAGE
om
1029 1252 RS. ISLAM MALANG ( UNISMA ) JL. MAYJEND HARYONO NO. 139 IBU.IKA MARKETING0341-
551356,580798,565448|0341-551257 Y Y Y ACTIVE ALL COVERAGE [email protected]
1030 0252 RS. ISLAM AISYIYAH MALANG JL. SULAWESI, NO.16 IBU HANNI MARKETING 0341-326773| 0341-368883 Y Y Y ACTIVE ALL COVERAGE [email protected]
1031 1978 RS. MUTIARA BUNDA MALANGJL. CIUJUNG NO 19, MALANG JAWA
TIMURKuswadji MARKETING (0341) 400403; 400722| - Y Y Y ACTIVE ALL COVERAGE
1032 1327 RSIA. HUSADA BUNDAJL. PAHLAWAN TRIP NO. 2, ORO-ORO
DOWO
IBU FITRI YUNI
LESTARIHumas/Marketing
(0341) 569634;
566972;569799; 580169|
0341-
580169/569799Y Y Y ACTIVE ALL COVERAGE [email protected]
1033 0094 RSU. HERMINA TANGKUBANPRAHU JL. TANGKUBAN PRAHU, NO.33
IBU ENDROWATI/
IBU JUNIOR
INDRIYANI S.
MARKETING
0341-325082 - 354844 -
354845/460341-
354844/8|0341-354844/8
0341-354843 Y Y Y ACTIVE ALL COVERAGEtangkubanprahu@herminahospit
algroup.com
MOJOKERTO
1034 0785 RS. EMMA JL. RAYA IJEN WATES NO.67 IBU NUR CHOLIPAH MARKETING 0321-328737-|- 0321-334021 Y Y Y ACTIVE ALL [email protected]
1035 0088 RS. KARTINI MOJOKERTO JL. ERLANGGA, NO.137, MOJOSARI BPK. AGUS MARKETING 0321-592261| 0321-595569 Y Y Y ACTIVE ALL COVERAGE [email protected]
1036 2818 RS. MUTIARA HATIJL. RAYA KEMANTREN WETAN 49,
TERUSAN,GEDEG, MOJOKERTOFATWA AMALIA MARKETING (0321) 7223400, 363442| - Y Y Y ACTIVE ALL COVERAGE
[email protected]/rsmuti
1037 0928 RS. GATOEL MOJOKERTO JL. RADEN WIJAYA NO.56 ZUROTUL AINI MARKETING0321-
321681,322329,399772-|-0321-321684 Y Y Y ACTIVE ALL COVERAGE [email protected]
1038 1980 RS. SIDO WARASJL. RAYA PASAR SAWAHAN KM. 10
BANGSAL KAB. MOJOKERTOIBU EVI MARKETING 0321-598621| 0321-598624 Y Y Y ACTIVE ALL COVERAGE [email protected]
1039 3825 RSI. SAKINAH JL. RA BASUNI NO.12 MOJOKERTO IBU ALFU LAYLA MARKETING 0321-321922| 0321-329670 Y Y Y ACTIVE ALL COVERAGE [email protected]
1040 1997RS. ISLAM HASANAH
MUHAMMADIYAH
JL. HOS. COKROAMINOTO NO.26 - 28,
MAGERS. ARI,MOJOKERTO, JAWA
TIMUR 61313
IBU YATI - 0321-321635| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1041 0164 RS. REKSA WALUYA JL. MOJOPAHIT, NO.422IBU ESTER/ DR.
KRISTANTOMARKETING
0321-322170/3221710321-
322171/3937|0321-
322171/3937
0321-322511 Y Y Y ACTIVE ALL COVERAGE [email protected]
NGAWI
1042 3872 RS. AT-TIN HUSADA JL. RAYA NGAWI-SOLO KM 4 BAPAK NOVIMANAGER
MARKETING0351747888| 351747666 Y Y Y ACTIVE ALL COVERAGE
marketing.rsiattinhusada@gmail.
com
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 38 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALIPACITANPAMEKASAN
1043 3811 APOTEK KIMIA FARMA 274 JL. DIPONEGORO No 4, PAMEKASAN SAFITRI YULIANTI - 0324611332| N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PASURUAN
1044 3626 KIMIA FARMA 165JL. WAHIDIN SUDIRO HUSODO NO 59
PASURUANSYAIFUL A - 0343-426342| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PONOROGO
1045 0823 RSU. AISYIYAH PONOROGO JL. DR SUTOMO NO.18-24DR. ENTI / IBU
YUNIKASEKRETARIAT
0352-
481784,461560,485093|0352-484218 Y Y Y ACTIVE ALL COVERAGE
m
PROBOLINGGO
1046 4081 RS. RIZANIJL. RAYA SURABAYA SITUBONDO KM
135, KEL SUMBEREJO, KEC PAITONBPK RIDWAN Marketing 0335 773444| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1047 0309 RS. DHARMA HUSADA JL. SOEKARNO HATTA NO.10 BPK. KOKOHUMAS &
MARKETING0335-422176| 0335-422698 Y N Y ACTIVE ALL COVERAGE [email protected]
1048 1330 RSU. WONOLANGAN JL. RAYA DRINGU NO.118DR.H.PRIYATNO/BP.
AFITMARKETING 0335-424007| 0335-431937 Y Y Y ACTIVE ALL COVERAGE [email protected]
SIDOARJO
1049 3839 APOTEK KIMIA FARMA 119 PERUM DELTASARI BLOK AN NO 11 SRI SUPADMI.S.SI - 0318556411| 318556411 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1050 3847 APOTEK KIMIA FARMA 261 JL. MAJAPAHIT NO.35 SIDOARJOVALIANDRI
PUSPANDINI- 0318956674| 318956674 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1051 0545RS. SITI KHODIJAH SEPANJANG
SIDOARJOJL. PAHLAWAN, NO.260, SEPANJANG IBU HANUM KEUANGAN
031-
7881130,7882123,7872081,
60134373|
031-7876066 Y Y Y ACTIVE ALL COVERAGE [email protected]
1052 1108 RSAB. SOERYAJL. RAYA KALIJATEN, NO.11-15, TAMAN
SEPANJANG
BPK.KURNIA
WITJAKSONOMARKETING 031-7885011-|- 031-7873633 Y Y Y ACTIVE ALL COVERAGE [email protected]
1053 3845 APOTEK KIMIA FARMA 180 JL. PAHLAWAN NO.10 SIDOARJODRA.DIAN
NURMAWATI- 0318947116| 318947116 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1054 3857 APOTEK KIMIA FARMA KAHURIPAN JL. KAHURIPAN NO.57 SIDOARJO MARIA AYU S.FARM - 03151517736| 3151517736 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
kimiafarma.kahuripan57@gmail.
com
1055 2273 KLINIK & APOTEK KF 124JL. RAYA SEDATI GEDE NO. 59
SIDOARJOAGUS CAHYANA - 031 867 5751| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1056 2755 RSU. BUNDA SIDOARJOJL. KUNDI NO.70 KEPUH KIRIMAN,
WARU SIDOARJOIBU TUTI Marketing (031) 8668880| (031) 8688218 Y Y Y ACTIVE ALL COVERAGE [email protected]
1057 1336 KLINIK CITRA GADING MEDIKAJL. BRIGJEN KATAMSO BLOK A 408-409
REWIN WARUBPK. SUWAJI KOORDINATOR 031-8679727| 031-8683181 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
om
1058 1339 KLINIK GRAHA MEDICA JL. BRIGJEN KATAMSO NO.7 WARU IBU SULIS HUMAS 031 - 8554910| 031-8554911 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1059 1342 KLINIK MEDIS GELORAPERUM TAMAN PINANG INDAH, BLOK
B7, NO.3-3AIBU IMA MARKETING 031-8929139| 031-8929123 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
[email protected]/ptgelo
1060 0249 RS. DELTA SURYA JL. PAHLAWAN NO.9 IBU YANNI MARKETING031-8962531-8961271031-
8961271|031-8961271
031-
8961281/8944977Y Y Y ACTIVE ALL COVERAGE
[email protected]/delta-
1061 0927 RS. ANWAR MEDIKA
JL. DUSUN SEMAWUT, RT.10/RW.04,
KEC. BALONGBENDO / JL. RAYA BY
PASS KRIAN KM.33
IBU IKOT/WANTI MARKETING 031-8972052, 8974943-|- 031-8988313 Y Y Y ACTIVE ALL [email protected]/an
1062 0271 RS. ISLAM SITI HAJAR SIDOARJO JL. RADEN PATAH NO.70 BPK REZA MARKETING 031-8921233/8961570|031-
8944438/8944990Y Y Y ACTIVE ALL COVERAGE [email protected]
1063 1040 RS. MITRA KELUARGA WARU JL. RAYA LETJEN. S.PARMAN, NO.8 IBU ELIS MARKETING 031-8543111/8542111-|- 031-8534333 Y Y Y ACTIVE ALL [email protected]/elis.mi
SITUBONDO
1064 3096 RS. ELIZABETH PTP NUSANTARA XI JL. WR SUPRATMAN 2A SITUBONDO DWI AGUS MARKETING 0338-671174| 0338-678061 Y Y Y ACTIVE ALL COVERAGE [email protected]
SURABAYA
1065 0917 RS. WILLIAM BOOTH SURABAYA JL. DIPONEGORO NO.34 IBU PAULINPELAYANAN
ASURANSI031-5678917-|-
031-
5624868,5671380Y Y Y ACTIVE ALL COVERAGE
rs.williamboothsurabaya@yahoo.
co.id
1066 1163 BRAIN CLINIC JL. SULAWESI, NO.63 DRG.MELANY - 031-5018800/031-5038004| - N Y Y ACTIVE ALL COVERAGE -
1067 0980 RS. ISLAM SURABAYA JL. JEND A YANI NO.2-4 IBU LOVA/BPK BUDI MARKETING 031-8284505-|- 031-8291805 Y Y Y ACTIVE ALL COVERAGE [email protected]
1068 3837 APOTEK KIMIA FARMA 52 JL. DUKUH KUPANG NO.54 DRS. SURYADI,APT - 0315671773| 315665755 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 39 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1069 3843 APOTEK KIMIA FARMA 166 JL. A.YANI 228 SURABAYA
DRA.RENY
BESYANITA- 0318291785| 318291785 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1070 3844 APOTEK KIMIA FARMA 175JL. KARANG MENJANGAN NO.9
SURABAYAAYU IRAWATI - 0315991991| 315991991 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1071 3846 APOTEK KIMIA FARMA 243 JL. RAYA ARJUNO NO.151 SURABAYA SARI RAKHMAWATI - 0315345031| 315459789 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1072 0809 RS. SPESIALIS HUSADA UTAMA JL. PROF DR MOESTOPO 31-35IBU TATIK DYAH
WULANDARIMARKETING
031-
5017975/5018335(021)
9100682|(021) 9100682
031-5018337 Y Y Y ACTIVE ALL [email protected];
1073 3848 APOTEK KIMIA FARMA 304 JL. PERAK TIMUR NO.166 SURABAYA IRMA NURYANTIE - 0313550007| 313550007 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1074 3850 APOTEK KIMIA FARMA 407 JL. MULYOSARI NO.288 SURABAYA HANS ALARKIE - 0315937994| 315937994 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
onestophealtcaremulyasari@gma
il.com
1075 2001 RS. WIYUNG SEJAHTERAJL. KARANGAN PDAM NO.1-3 WIYUNG
SURABAYAIBU SURIYAH MARKETING (031) 7532653| (031) 7533726 Y Y Y ACTIVE ALL COVERAGE [email protected]
1076 0830 RS. ADI HUSADA UNDAAN WETANJL. UNDAAN WETAN NO40-44
SURABAYADR.ANANG PITOYO
KOORDINATOR
MARKETIN
031-5321256031-
5318000|031-5318000031- 5321081 Y Y Y ACTIVE ALL COVERAGE
om
1077 2272 APOTEK KIMIA FARMA 35JL. NGAGEL JAYA SELATAN NO. 107
SURABAYA 60258AGUS CAHYANA - 031 504 1276, 504 9098| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1078 2212 APOTEK FARMARIN SURABAYA JL. JEMUR ANDAYANI II/1, SURABAYASETIA.N, S.FARM,
APT- 031-8418190| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1079 2217 RS. KENDANG SARI SURABAYAJL. RAYA KENDANGSARI NO.38
SURABAYAIBU DINI marketing 031-8436200/8437200| 031-8494484 Y Y Y ACTIVE ALL COVERAGE [email protected]
1080 2315 NATIONAL HOSPITAL SURABAYABOULEVARD FAMILI SEL KAV 1 GRAHA
FAMILI, SURABAYA
IBU.LULU / IBU.MEI
MUNAWAHDivisi Marketing 031-2975777| 031-297799 Y Y Y ACTIVE ALL COVERAGE [email protected]
1081 2476 RS. ROYAL SURABAYA JL. RUNGKUT INDUSTRI I/ 1 SURABAYA SANDRA RAHESTI - 031-8476111| 031-8476211 Y Y Y ACTIVE ALL COVERAGE [email protected]
1082 2785RS. ORTHOPEDI DAN
TRAUMATOLOGY
JL. EMERALD MANSION TX 10
CITRALAND, SURABAYA
DR. KARINA
DARMANTOMARKETING (031) 57431299| (031) 57431255 Y Y Y ACTIVE ALL COVERAGE
om
1083 2786 RS. PURA RAHARJA JL. PUNCANG ADI 12-14 SURABAYA IBU ERNA RISMA -(031) 5019898/ 5022151/
5024591|- Y Y Y ACTIVE ALL COVERAGE
1084 1362 RS. BHAKTI RAHAYU SURABAYA JL. KETINTANG MADYA I/16 IBU ASMANI MARKETING
031-
8295922/8291799/8299217
/23|
031-8293839 Y Y Y ACTIVE ALL COVERAGE -
1085 1363 RS. BUNDA SURABAYAJL. RAYA KANDANGAN NO.23-24
BENOWOBPK.AFIT MARKETING
031 -
7442220/7440077/7400694
|
031 - 7442133 Y Y Y ACTIVE ALL COVERAGE [email protected]
1086 1365 RS. MATA UNDAAN JL. UNDAAN KULON, NO.19 BPK ARNOLD Marketing 031-5343806/531619| 031-5317503 Y Y Y ACTIVE ALL COVERAGEmarketing.rsmataundaan@gmail
.com
1087 1453 RS. ONKOLOGIARAYA GALAXI BUMI PERMAI BLOK
A2/7 JL. ARIEF RAHMAN HAKIM 182BP. BUDIONO MARKETING 031-5914855| 031-5914860 Y Y Y ACTIVE ALL COVERAGE [email protected]
1088 1454RSIA. PUTRI ( RS. KHUSUS
OBSTETRI & GINEKOLOGI )JL. ARIF RAHMAN HAKIM, NO.122
IBU
LESTARI/BPK.HARRY
SEKRETARIS
DIREKTUR031-5999987| 031-5997215 Y Y Y ACTIVE ALL COVERAGE [email protected]
1089 1201 RS. ADI HUSADA KAPASARI JL. KAPASARI NO.97-101 DR.DANI, IBU PIPIN MARKETING 031-3764555| 031-3764666 Y Y Y ACTIVE ALL COVERAGE [email protected]
1090 1690 RS. BEDAH SURABAYA JL. RAYA MANYAR NO 9 SURABAYA IBU DWIKA/ TIAS MARKETING 031-5999369,5999339| 031-5995284 Y Y Y ACTIVE ALL COVERAGErumahsakitbedahsurabaya@gma
il.com
1091 1364 RS. ISLAM SURABAYA JEMURSARI JL. JEMURSARI NO.51-57BPK DICKY, IBU
FARIDAMARKETING
031 -
8471877/8471878/8471889
|
031-8437784 Y Y Y ACTIVE ALL [email protected]/faridar
1092 0136 RS. MITRA KELUARGA SURABAYA JL. SATELIT INDAH II, DARMO SATELIT IBU SELLY MARKETING 031-7345333| 031-7345955 Y Y Y ACTIVE ALL [email protected]
1093 0163 RS. DARMO JL. RAYA DARMO, NO.90IBU LARASATI/ BP
MITRAMARKETING 031 - 567 6253/54/55/56| 031-5620690 Y Y Y ACTIVE ALL COVERAGE [email protected]
1094 0544RS. ST.VINCENTIUS A.PAULO (RS.
RKZ)JL. DIPONEGORO NO.51 IBU VIDYA MARKETING
031-
5677562,5687846,5663895
031-5687846|031-5687846
031-
5674748/5651057Y Y Y ACTIVE ALL COVERAGE
1095 0895RS. PRIMASATYA HUSADA CITRA (
PHC )
JL. PRAPAT KURUNG SELATAN NO.1
TANJUNG PERAKBPK.NORWENDO MARKETING 031-3294801-3-|- 031-3294804 Y Y Y ACTIVE ALL COVERAGE
1096 0896 KLINIK KEBRAON JL. GRIYA KEBRAON BLOK FA NO.37 BPK HARI SANTOSO PENGELOLA 031-7663816-|- 031-7663816 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
1097 0897 KLINIK BENOWO PONDOK BENOWO INDAH, BLOK PP/22 DR. SHELLA KOORDINATOR 031-70547492-|- - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1098 0081 SILOAM HOSPITALS SURABAYA JL. RAYA GUBENG NO. 70, SURABAYA IBU ADI/ IBU YUNI MARKETING 031-5031333/5031821|031-
5031533/5039313Y Y Y ACTIVE ALL COVERAGE
m
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 40 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1099 2925 RS. MITRA KELUARGA KENJERAN JL. KENJERAN 506 SURABAYA 60114 DEWI MUNAWAROH Marketing (031) 99000880| (031) 99000885 Y Y Y ACTIVE ALL [email protected]
m
1100 3851 APOTEK KIMIA FARMA 432 PANDUGO JL. PANDUGO MERR NO.2 SURABAYAWIRA
KUSUMA.S.FARM- 0318709962| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1101 3852 APOTEK KIMIA FARMA G-WALKRUKO TAMAN GAPURO B.2, G-WALK
SURABAYA
FENITASARII.S.FAR
M- 0317411121| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1102 3853 APOTEK KIMIA FARMA WIYUNGRUKO TPI BLOK A 17 RAYA MEGANTI
SURABAYA
DERRY
SUSANTI.S.FARM- 0317668267| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1103 3855 APOTEK KIMIA FARMA CILIWUNG JL. CILIWUNG NO.76 SURABAYATINJUNG
DESMARANTI- 0315633156| 315633156 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1104 3856 APOTEK KIMIA FARMA KLAMPISJL. KLAMPIS JAYA BLOK A NO.30
SURABAYA
KURNIA PUSPITA
NINGRUM- 0315926293| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1105 3858 APOTEK KIMIA FARMA RUNGKUT JL. RUNGKUT MADYA NO.97 SURABAYAKHOLIFATUS
SADIYAH.S.FARM- 0318721059| 318721059 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1106 3197 RS. SURABAYA MEDICAL SERVICE JL. KAPUAS NO. 2 SURABAYA BPK ANANG - 031-5686161| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1107 3002 LAB. KLINIK BIOTEST SURABAYAJL. RA. KARTINI NO.78, SURABAYA,
JAWA TIMUR
IBU RICI
(08122316492)MARKETING (031) 5673498| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1108 3390RSIA. LOMBOK DUA DUA ( JL.
FLORES)JL. FLORES NO. 12 SURABAYA RESTI / RATNA
Markting /
Keuangan031- 5022044| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1109 0829RS. PREMIER SURABAYA (RS.
SURABAYA INTERNASIONAL)JL. NGINDEN INTAN BARAT, BLOK B
BPK WIDODO/ IBU
IRAMARKETING 031- 5993211|031-5993211 031- 5993214 Y Y Y ACTIVE ALL COVERAGE
rspremier.surabaya@ramsayheal
th.co.id
1110 4209 RS. WIJAYA SURABAYA JL. MENGANTI 398 WIYUNG SURABAYA PAK BOBBY - 031-7523087/031-7523282| Y Y Y ACTIVE ALL [email protected];
1111 3831 APOTEK KIMIA FARMA 22 JL. BRATANG GEDE NO.100 A SurabayaDRS. HERU
SUMEHORO- 0315016713| 315016713 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1112 3832 APOTEK KIMIA FARMA 23 JL. KENDANGSARI BLOK J NO.7 DRS. ARI WAHYUDI - 0318414215| 318419345 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1113 3833 APOTEK KIMIA FARMA 24 JL. DHARMAWANGSA NO.24DRS. AKHMAD
YANI,APT- 0315032775| 315037664 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1114 3834 APOTEK KIMIA FARMA 25 JL. RAYA DARMO NO.2-4ACHMAD
MUJIANTORO- 0315677777| 315666454 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1115 3835 APOTEK KIMIA FARMA 26 JL. DIPONEGORO NO.94DRS. NONO
SUMARNO- 0315677007| 315664420 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1116 3836 APOTEK KIMIA FARMA 45 JL. RAYA DARMO NO.94DRS. HERI
SUMANTO- 0315676301| 315678819 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
TUBAN
1117 1198 RS. MEDIKA MULIA TUBAN JL. MOJOPAHIT, NO.699 TUBAN BPK.EKO MARKETING 0356-322744/324618| 0356-322666 Y Y Y ACTIVE ALL COVERAGE [email protected]
1118 2002 RS. NAHDATUL ULAMA TUBAN JL. LETDA SUCIPTO NO 211 TUBAN
IBU
MARTIANAWATI,M.K
ES
MARKETING0356-328244/(0356)
328299|(0356) 712072 Y Y Y ACTIVE ALL COVERAGE [email protected]
TULUNG AGUNG1118 0813 RS. ISLAM ORPEHA JL. KH. R. ABDUL FATAH IBU WIDI KASI- PERAWAT 0355-323186| 0355-327691 Y Y Y ACTIVE ALL COVERAGE [email protected]
1119 3826 RS. ERA MEDIKAJL. RAYA PULOSARI, NGUNUT,
TULUNGAGUNG, JAWA TIMUR
IBU VICA
DESTRIANAMARKETING
0355-398706/396566/
08155199111|0355-398706 Y Y Y ACTIVE ALL COVERAGE
[email protected]/d_que
1120 3708 APOTEK KIMIA FARMA 392JL. I GUSTI NGURAH RAI NO. 10
TULUNGAGUNGBP. PUJI SANTOSO SPV PELAYANAN 0355-322308| 0355-322308 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
KETAPANG
1121 1800 RS. FATIMA KETAPANG JL. JEND SUDIRMAN NO. 27 KETAPANG DR INDAH - 0534-32814| 0534-31649 Y Y Y ACTIVE ALL COVERAGE -
PONTIANAK
1122 2729 RS. MITRA MEDIKA PONTIANAKJL. SULTAN ABDURRAHMAN NO.25,
PONTIANAK, KALBAR
IRMINA
(081345274813)- (0561) 584888| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1123 1106 RS. SANTO ANTONIUS JL. KH. WAHID HASYIM NO.249IBU LENA/ BP
VIEDNOMarketing 0561-732101-|-
0561-
742242/733623Y Y Y ACTIVE ALL COVERAGE [email protected]
1124 1431RSIA. ANUGERAH BUNDA
KHATULISTIWAJL. AHMAD YANI NO. 5-7
NOVI INDRAWAN,
IBU YUNI,MARKETING 0561-581818| 0561-584100 Y Y Y ACTIVE ALL COVERAGE
1125 1036 RS. KHARITAS BHAKTI JL. SIAM, NO.153 PONTIANAK IBU AFI MARKETING 0561-734373-|- 0561-768969 Y Y Y ACTIVE ALL COVERAGE [email protected]
1126 2679 KIMIA FARMA SEI RAYAJL. SEI RAYA DALAM,RUKO B1,
PONTIANAK
DRS. NISAMUDDIN,
APT- 0567-737797| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
KALIMANTAN BARAT
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 41 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1127 2253 KLINIK & APOTEK KF 32 PONTIANAK
JL. TANJUNG PURA NO. 419,
PONTIANAKBPK TIGOR - 0561-731658| 0591-735802 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1128 2254APOTEK KIMIA FARMA 371
PONTIANAKJL. AHMAD YANI NO. 5, PONTIANAK BP FALAH - 0561-713988| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1129 2255 KIMIA FARMA 333 PONTIANAKJL. WAHID HASYIM NO. 60,
PONTIANAKIBU METI - 0561-768140| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
SINGKAWANG
1130 2621 RSU. HARAPAN BERSAMAJL. N. P. BELITUNG NO. 61)
SINGKAWANG
IBU SUSI/IBU
AYU/IBU WIWIN- 0562-631791| 0562-633359 Y Y Y ACTIVE ALL COVERAGE [email protected]
1131 1368RS. SANTO VINCENTIUS
SINGKAWANGJL. P. DIPONEGORO NO.5
IBU
MAEMUNAH/KRISTI
N/DR. MELDA
MARKETING 0562-631008| 0562-633881 Y Y Y ACTIVE ALL COVERAGE [email protected]
BANJARMASIN
1132 2237 KIMIA FARMA 188JL. LETJEN S. PARMAN NO. 42
BANJARMASINIBU MARLINI - 0511-3354020| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1133 2235 KLINIK & APOTEK KF NO.61 JL. VETERAN NO. 51 BANJARMASIN BPK BAHRUDIN APOTEKER 0511-3250682/3252779| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1134 2236 APOTEK KIMIA FARMA 217JL. A. YANI KM 2 NO. 136
BANJARMASINBPK. HIDAYAT APOTEKER 0511-3252250/3251369| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1135 0763 RS. SUAKA INSAN JL. H.ZAHRI ZAMZAM NO.60
IBU
HILDA/SUS.FLORDE
RISA
HUMAS/TATAUSAH
A0511-3356280/81| 0511- 55122 Y Y Y ACTIVE ALL COVERAGE [email protected]
1136 0631 RS. SARI MULIA JL. PANGERAN ANTASARI NO. 139B IBU ADIT/BPK.APRI MARKETING
0511 -
3274447/3261491/3252570
0511-266960|0511-266960
0511 - 3257889 Y Y Y ACTIVE ALL [email protected];
1137 0849 RS. ISLAM BANJARMASINJL. LET JEN S PARMAN GG.PURNAMA
NO.1 BANJARMASIN
IBU NURUL/ BPK
GUSTIHUMAS
0511-3350332, 3354896,
3350335|0511-3350332/350511-3351690 Y Y Y ACTIVE ALL COVERAGE [email protected]
1138 1758 KLINIK SPESIALIS SARI MULIA JL. PANGERAN ANTASARI NO. 139 B BP APRI KEUANGAN
0511-
3254341/3266960/3252570
|
0511-3266960 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
KANDANGAN
1139 1799 RS. PAHLAWAN MEDIKA CENTERJL. PAHLAWAN NO. 15 KANDANGAN
KAB. HULU SUNGAI SELATANIBU FUJI MARKETING 0517-23191| 0517-23678 Y Y Y ACTIVE ALL COVERAGE [email protected]
MARTAPURA
1140 1797 RSIA. MUTIARA BUNDA MARTAPURA JL. TAISIR NO. 2, MARTAPURAANDRI TRI
CAHYONOMARKETING O511- 4721901| 0511- 4720664 Y Y Y ACTIVE ALL COVERAGE [email protected]
1141 2721 RS. PELITA INSANIJL. SEKUMPUL NO.66 MARTAPURA
70614, KALIMANTAN SELATANINDRA ATMAJA MARKETING (0511) 4722210, 4722220| (0511) 4722230 Y Y Y ACTIVE ALL COVERAGE [email protected]
TABALONG
1142 2707 RS. PERTAMINA TANJUNG
JL. GAS, KOMPERTA MURUNG PUDAK
TANJUNG, KALIMANTAN SELATAN
71571
IBU RITA/ DR
RAHMAWATIWadir (0526) 2022550/2023068| (0526) 2027678 Y Y Y ACTIVE ALL COVERAGE -
TANAH BUMBU
1143 1011 KLINIK SURYA MEDIKA SATUI (SMS)JL. PROPINSI NO 11, RT 17 SUNGAI
DANAU SATUIDR ZAINAL DIRETUR 0512-61717|0778-322122 0512-61312 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
o.id
1144 3996 KLINIK SIMPANG TANAH BUMBU
JL. GAWE SABUMI RT 08 NO. 083,
DESA BERSU. JUD,KEC. SIMPANG
EMPAT, KAB. TANAH BUMBU,
KALIMANTAN SELATAN 72200
DR DINA -(081258339911 /
081953230699)|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1145 2471 KLINIK MEDIKA BATULICIN
JL. RAYA BATULICIN - SERONGGO KM.
1 SEI KECIL, BATULICIN, TANAH
BAMBU - KALSEL
- - 0518-71570| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PALANGKARAYA
1146 2889RS. ISLAM PKU MUHAMMADIYAH
PALANGKARAYA
JL. RTA MILONO KM .2,5 MENTENG,
JEKAN RAYA PALANGKARAYA
ALFIAN
FADILLAH/SRI
ROKAYAH
MARKETING 0536-3244801/3239444| 5363244802 Y Y Y ACTIVE ALL COVERAGE [email protected]
1147 1377 RSUD DR. DORIS SYLVANUS JL. TAMBUN BUNGAI NO.4IBU RUSBINI / IBU
INA UDIATIMarketing 0536-3224217| 0536-3229194 Y Y Y ACTIVE ALL COVERAGE [email protected]
PANGKALAN BUN
1148 3529 KLINIK KESUMAJL. ISKANDAR NO. 12 A, PANGKALAN
BUN, KALIMANTAN TENGAHOSCAR VIYARISA MARKETING (0532) 23935| (0532) 23935 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
KALIMANTAN SELATAN
KALIMANTAN TENGAH
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 42 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALISAMPIT
1149 4085 KLINIK SARI MEDIKA SAMPIT JL. P.ANATASARI NO 5 SAMPITDR. YULIA / IBU
MIRNA053125288| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
BALIKPAPAN
1150 1520 APOTEK KIMIA FARMA 56 JL. A.YANI, NO.95 BPK. SUBEKTI - 0542-424187,7031852| 0542-731560 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1151 3459 SUMATERA EYE CENTRE BALIKPAPANRUKO SENTRA EROPA BLOK AA 2B
NO.16 BALIKPAPAN BARUBP.ULLISYS koordinator (0542) 876732/876941| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
smec_balikpapan@smec-
group.com/[email protected]
1152 0686 PANACEA CLINICKOMP MAL FANTASI BLOK AB2 NO.18-
20 BALIKPAPAN BARU 76114IBU Maya KOORDINATOR
0542-877898,72040460751-
444712/5|0751-444712/5
0542-
877641/7031819N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
id
1153 0692 APOTIK KANIDA FARMA II JL. JEND. SUDIRMAN, NO. 239 IBU RINI MARKETING0542-424309,0542
420496|0542-4204960542-424031 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1154 0633 RS. PERTAMINA BALIKPAPAN JL. JEND SUDIRMAN NO.1 IBU REISA DELSIA MARKETING 0542-7517485/734020/21| 0542-7517493 Y Y Y ACTIVE ALL [email protected];custom
1155 1213 RS. BALIKPAPAN BARUKOMP. BALIKPAPAN BARU JL.
MT.HARYONO BLOK. A-A3
IBU
GANIS/BPK.YANTOSEKRETARIS 0542-877330| 0542-877331 Y Y Y ACTIVE ALL COVERAGE
1156 0672 RSIA. PERMATA HATI BALIKPAPAN JL. IMAM BONJOL NO.1IBU NENENG/IBU
HAPSARIKEUANGAN 0542-413932/413928| 0542 - 413928 Y Y Y ACTIVE ALL COVERAGE
hapsari.dewi@rs-
permatahati.com
1157 0632 RS. RESTU IBU JL. JEND. A. YANI, NO.12 BP RURY MARKETING0542-427342/3/40542-
427342|0542-427342
0542-
441494/417290Y Y Y ACTIVE ALL COVERAGE
1158 2635 KLINIK & APOTEK KF 329 JL. SOEKARNO HATTA KM 5 / 86, BPNERMANSYAH
SIREGAR.S.SI.,APT- 0542 860024| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1159 2634 KLINIK & APOTEK KF SEPINGGAN JL. MARS. MA ISWAHYUDI NO. 72
APRILYANI
KUSUMAWATI,S.FAR
M.,APT
- 0542 7310391| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1160 2633 KLINIK & APOTEK KF 68JL. JEND.SUDIRMAN NO.2-3
PERTOKOAN KLANDASAN
ANGGA TRI
SAPTA.S.FARM.,APT- 0542 422691| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1161 2632 KLINIK & APOTEK KF 293 JL. A. YANI NO.45 KARANG JATI
AANG
ROYYANA.S.FARM.,A
PT
- 0542 413090| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1162 1457KLINIK & APOTEK KF 136
BALIKPAPANJL. MT. HARYONO NO. 72 BPK.WINASTANTO KOORDINATOR 0542-763962| 0542-761629 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1163 1374SILOAM HOSPITALS BALIKPAPAN (RS
BALIKPAPAN HUSADA)
JL. MT.HARYONO NO.9 RINGROAD,
BALIKPAPAN - KALIMANTAN TIMUR
DR.BAYU
A/ISWANDI KMARKETING 0542 - 8862 999| 0542-7206517 Y Y Y ACTIVE ALL COVERAGE [email protected]
1164 2073KLINIK MEDIKA UTAMA ( KMU
SETIARA )
JL. MULAWARMAN NO. 24 RT 7
MANGGAR BARU BALIKPAPAN,
KALIMANTAN TIMUR
CAHYA AYU - 0542-770846| 0542-770847 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
BONTANG
1165 2118 RS. AMALIA BONTANGJL. R. SOEPRAPTO NO. 22 BONTANG
BARU, KOTA BONTANG KALTIMBPK CHA HRD 0548-25050| 0548-23275 Y Y Y ACTIVE ALL COVERAGE [email protected]
1166 2474 KLINIK RS. PKT 1 JL. IMAM BONJOL BONTANG-KALTIM - - 0548-24800| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1167 1214 RS. PUPUK KALTIM BONTANGJL. OKSIGEN NO.1, KOMP.PUPUK
KALTIMBPK.SAHARUDIN MARKETING 0548-41118/41444| 0548-41555 Y Y Y ACTIVE ALL COVERAGE
[email protected]/suko_rs@yah
oo.co.id
KUTAI KARTANEGARA
1168 1074 KLINIK MAJU SEJAHTERAJL. MOH. HATTA, HANDIL 3, MUARA
JAWAIBU INDRI/ ELIN MANAGER KLINIK
0541-691891/
081333001836-|-0541-691892 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
SAMARINDA
1169 3813 KLINIK & APOTEK KF 385 (PPO) JL. P.M.NOOR SAMARINDA ERISKA - 0541-220286| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1170 3460 SUMATERA EYE CENTRE SAMARINDA JL. A. YANI NO. 6 A-B SAMARINDA BP.BOY ANDRIAN Koordinator (0541) 200257, 200258| - Y Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
smec_samarinda@smec-
group.com/[email protected]
m
1171 0636 RS. DIRGAHAYU JL. GN. MERB. ABU, NO. 62IBU MARDALENA/
IBU VEROKEPALA HUMAS
0541-
742161/748309/748310054
1-748309/10/11|0541-
748309/10/11
0541-
748308/744636Y Y Y ACTIVE ALL COVERAGE [email protected]
1172 1794 RSIA. THAHA BAKRIEJL. PANGERAN HIDAYATULLAH NO 11
SAMARINDAIBU FANI MARKETING 0541-742191| 0541-200075 Y Y Y ACTIVE ALL COVERAGE [email protected]
1173 1656 KLINIK MELATI HUSADA
JL. CIPTO MANGUN KUSUMO RT 12 NO
52 KEL SENGKOTEK LOA JUAN
SAMARINDA
DR HALIDA PEMILIK 0541-260721| 0541-241752 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
KALIMANTAN TIMUR
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 43 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1174 2104 KLINIK & APOTEK KF 105 JL. DR. SUTOMO NO 36-37 SAMARINDA SUTARNO APOTEKER -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1175 2105 KLINIK & APOTEK KF 138 KARTIKAJL. KH AGUS SALIM NO. 30
SAMARINDA 75121
BPK. AHMAD ANDI
RIVAIAPOTEKER 0541-737447| N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1176 0635 RS. ISLAM SAMARINDA JL. GURAMI, NO.18 IBU JURIANTI MARKETING 0541 - 741510/731857| 0541 - 731856 Y Y Y ACTIVE ALL COVERAGE [email protected]
1177 2473 RS. SIAGA RAMANIAJL. RAMANIA 3 ( JL. JEND. SOEPARTO)
SAMARINDA, KALTIMBAPAK PION Penagihan 0541-739772| 0541-749131 Y Y Y ACTIVE ALL COVERAGE [email protected]
1178 2631 KIMIA FARMA 114JL. P.HIDAYATULLAH NO.63,
SAMARINDA
DRS. FAHARUDDIN,
APT- 0541 742198| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1179 2453 RS. SAMARINDA MEDIKA CITRAJL. KADRIE OENING NO.81 RT.35
SAMARINDA 75124ELMI YANTI MARKETING (0541) 7273000| (0541) 7272888 Y Y Y ACTIVE ALL COVERAGE [email protected]
1180 0230 RS. H. DARJAD JL. DAHLIA, NO.4 BPK HUDI/IBU LULU MARKETING0541-
732698,734123,732609|0541-732562 Y Y Y ACTIVE ALL COVERAGE [email protected];
SANGATTA
1181 1376RS. PKT PRIMA SANGATTA (RS.
PUPUK KALTIM )
JL. YOS SUDARS. O I NO.1 SANGATTA -
KALIMANTAN TIMURBPK RAHMAT SDM 054924555|
0549-24524;
25927Y Y Y ACTIVE ALL COVERAGE
[email protected]/prima@rspkt
.com
1182 3579 RS. PERTAMEDIKA AULIA SANGATTAJL. KARYA ETAM RT. 14 NO. 79,
SANGATTA 75611VICA WIJAYANTI MARKETING (0549) 2029456|
(0549)
2029404/20294Y Y Y ACTIVE ALL COVERAGE [email protected]
1183 1556 RS. MELOY SANGATTAJL. YOS SUDARS. O II NO.101
SANGATTA - KALIMANTAN TIMURBPK HARYUDI - 0549-2026258| 0549-24222 Y N Y ACTIVE ALL COVERAGE [email protected]
TARAKAN1182 1972 RUMKITAL ILYAS TARAKAN JL. MARTADINATA NO 29 - - 0551-24320 / 21353| - Y Y Y ACTIVE ALL COVERAGE -
1183 1529 RS. PERTAMINA TARAKAN JL. MULAWARMAN NO. 14, TARAKAN IBU HASNAMARKETING DAN
HUMAS0551-31403/31665| 0551-33310 Y Y Y ACTIVE ALL COVERAGE
BANDAR LAMPUNG
1184 0487 RS. ADVENT LAMPUNGJL. TEUKU UMAR, NO.48 KEDATON
BANDAR LAMPUNGBPK OTOT MARKETING 0721-703459|
0721-
786349/770717Y Y Y ACTIVE ALL COVERAGE [email protected]
1185 0486 RS. IMMANUEL WAY HALIM JL. SOEKARNO-HATTA, WAY HALIM IBU NOVI/IBU RINA Pelayanan Asuransi 0721-704900,704630/628|0721-
704807/784897Y Y Y ACTIVE ALL COVERAGE
[email protected]/rs_im
1186 1092 RS. MITRA HUSADA PRINGSEWUJL. JEND A. YANI NO.14 PRINGSEWU,
LAMPUNG
IBU SRI HARTATI /
IBU SERI
MARKETING EXT
1010729-23792-|- 0729-23836 Y Y Y ACTIVE ALL COVERAGE [email protected]
1187 1378 RS. URIP SUMOHARJOJL. URIP SUMOHARJO NO.200
SUKARAME
IBU
IDA/BP.BAMBANG
PELAYANAN
ASURANSI0721-771322/23/24|
0721-
771321/707990Y Y Y ACTIVE ALL COVERAGE [email protected]
1188 1313 RS. MARDI WALUYOJL. JEND SUDIRMAN NO 156 KOTA
METRO 34111 BD LAMPUNGBPK. YANTO Marketing 0725-42512/44980| 0725-7850499 Y Y Y ACTIVE ALL COVERAGE [email protected]
1189 1228 RS. BUMI WARAS JL. WOLTER MONGINSIDI, NO.235DR. ARIEF/ IBU
HESTIMarketing
0721-
254589/261122/257925/26
7855|
0721-257926 Y Y Y ACTIVE ALL [email protected];
1190 1692 RS. HARAPAN BUNDA LAMPUNGJL. RAYA LINTAS SUMATERA NO.30
SEPUTIH JAYA LAMPUNG TENGAHIBU ARI MARKETING 0725-26766| 0725-25091 Y Y Y ACTIVE ALL COVERAGE
[email protected]/aridaniasri
@rshb-lampung.co.id
1191 1693 RSIA. MUTIARA PUTRIJL. HOS COKROAMINOTO NO 76
ENGGAL LAMPUNGBPK LUTFI MARKETING 0721-252579/254999| 0721-254282 Y Y Y ACTIVE ALL COVERAGE [email protected]
1192 1699 RSB. ANUGERAH MEDIKAJL. KAPTEN ACHMAD IBRAHIM NO.
21/23 ENGGALBPK.GANJAR - 0721-240488/262310| Y Y Y ACTIVE ALL COVERAGE
m
1193 1632 RS. NATAR MEDIKA (YADIKA GROUP)JL. RAYA NATAR NO. 04 MUARA PUTIH,
KEC NATAR LAMPUNG SELATANAYU WANDIRA MARKETING 0721-92521/92519| 0721-92519 Y Y Y ACTIVE ALL COVERAGE
1194 1871 RS. PERTAMINA BINTANG AMIN JL. PRAMUKA NO 27, LAMPUNG BP FITER ROMILADO-- 0721-273601| 0721-273597 Y Y Y ACTIVE ALL COVERAGE [email protected]
1195 1352 RS. GRAHA HUSADA LAMPUNGJL. GAJAH MADA, NO. 6 GH, TANJUNG
AGUNG, BANDAR LAMPUNGIBU SHANTY S. HUMAS 0721-240000|
0721-
263181/268417Y Y Y ACTIVE ALL COVERAGE [email protected]
1196 1970 RSIA. BUNDA AS-SYIFAJL. DR.SUSILO NO. 54 PAHOMAN TELUK
BETUNG UTARA BANDAR LAMPUNGBAPAK ERI MARKETING
0721-
240474/259259/256256|0721-266800 Y Y Y ACTIVE ALL COVERAGE
[email protected]/wildi
1197 2110KLINIK & APOTEK KF 131 BANDAR
LAMPUNG
JL. KARTINI NO. 44-45 BANDAR
LAMPUNG- - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1198 2112KLINIK & APOTEK KF 327 BANDAR
LAMPUNG
JL. JEND. SUDIRMAN NO. 88 BANDAR
LAMPUNGPak Yacub Apoteker 0721- 5600608| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1199 2176 RSIA. RESTU BUNDAJL. K.H. HASYIM ASHARI NO. 73, TELUK
BETUNG SELATAN - BANDAR LAMPUNGIBU ANNA MARKETING 0721-484158/484185| 0721-482832 Y Y Y ACTIVE ALL COVERAGE [email protected]
1200 2465 RSIA. PURI BETIK HATIJL. PAJAJARAN NO.109, JAGABAYA,
BANDAR LAMPUNG, LAMPUNGBPK.ADHI WIJAYA - 0721-787799| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1201 2767 RS. ISLAM ASY-SYIFAA
JL. NEGARA LINTAS SUMATERA KM.65
YUKUM JAYA - BANDAR JAYA, KEC.
TERB. ANGGI BESAR, LAMPUNG
TENGAH 34162
BAPAK BOWO - (0725) 25264| (0752) 527476 Y Y Y ACTIVE ALL COVERAGE [email protected]
KALIMANTAN UTARA
LAMPUNG
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 44 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1202 0762 RS. YUKKUM MEDICAL CENTERJL. NEGARA NO 99, KM 67 YUKUM
JAYA, LAMPUNG TENGAHIBU NUR JUAMI MARKETING 0725-25333| 0725 - 25989 Y Y Y ACTIVE ALL COVERAGE [email protected]
LAMPUNG SELATAN
1203 3170 KLINIK DUA PUTRI JAYA
JL. IR. SUTAMI KM.30 DESA MALANG
SARI, TANJUNG SARI-LAMPUNNG
SELATAN
IBU PUTRI PIMPINAN 085366797190| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
AMBON
1204 2911 RS. T TK.II DR.J.A. LATUMETEN JL. DR. TAMAELA N0. 2 AMBON KAPTEN AANGBag.
Pengembangan0911-353555| 0911-354763 Y Y Y ACTIVE ALL COVERAGE [email protected]
1205 1439 RS. BHAKTI RAHAYU AMBON JL. BATU KERB. AU, BELAKANG RRI WELFRA ANDRIE MARKETING 0911-342746| - Y Y Y ACTIVE ALL COVERAGE -
1206 2265APOTEK KIMIA FARMA PEL.26
AMBON,MALUKU
JL. DR. KAYADOE, KEL. KUDAMATI,
AMBON-MALUKU(DI DALAM RS.
HALAUSSY)
BPK LUKAS - 0911-351677| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1207 2912 RS. SUMBER HIDUPJL. ANTHONY RHEBOK, HONIPOPU,
SIRIMAU, AMBON, MALUKUGRACE Marketing (0911) 352373, 351654| 0911-352401 Y N Y ACTIVE ALL COVERAGE [email protected]
TERNATE
1208 2260KLINIK & APOTEK KF 168 TAKOMA
TERNATE
JL. HASAN ESA 151 TERNATE, MALUKU
UTARABP TRI KURNIAWAN BM 0921-3121037/3123076| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1209 2012 RS. ISLAM TERNATE JL. PEMUDA NO. 131 KEL.TOBELEUIBU TUTI/IBU
RUGAYA
TATA
USAHA/HUMAS0921-3121623| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1210 1503 RS. MEDIKA HARIFALMJL. ZAINAL ABIDINSYAH, NO.25,
KOMPLEX POHON PALA- ADMINISTRASI 0921-3126087| 0921-3126198 Y N Y ACTIVE ALL COVERAGE [email protected]
BANDA ACEH
1211 1789 KLINIK SPECIALIS CEMPAKA LIMAJL. TENGKU M. DAUD BEUREUEH NO
156PAK JEFRI Personalia
0651-33345 /
08126922264|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1212 2187 APOTEK KIMIA FARMA LAMPRIETJL. TEUKU DAUD BEUREUEH NO. 167-
171
BPK. INDRA
PERMANAPIC 0651-637008| 0651-635 669 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1213 2186 APOTEK KIMIA FARMA 37 JL. DIPONOGORO NO 8BPK. INDRA
PERMANA- 0651-21559| 0651-635 669 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
1214 1790 RS. CEMPAKA AZ ZAHRAJL. POCUT BAREN NO 36-38-40 BANDA
ACEH
BPK KAMAL ZIZA/
IBU LIAMARETING 0651-31066| 0651-25281 Y Y Y ACTIVE ALL COVERAGE [email protected]
1215 3958APOTEK & KLINIK KIMIA FARMA 397
SIGLIJL. PERDAGANGAN NO.1 SIGLI - ACEH
M.BAGUS ANDREAS
TMARKETING 065321536| 65321536 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1216 1100 RS. TEUNGKU FAKINAH JL. JEND. SUDIRMAN NO.27-29BPK.TONI ZEIN /
IBU ASIHTATA USAHA
0651-41454 /
081377028888-|-0651-47646/49454 Y N Y ACTIVE ALL COVERAGE [email protected]
BIREUN
1217 1694 RS. TELAGA BUNDA BIERUN JL. PEUTUA BANTA NO 7, GP BIERUNBPK NURDIN / DR
NILA ETITA
MARKETING/
DIREKTUR0644-324433| 0644-324433 Y Y Y ACTIVE ALL COVERAGE [email protected]
LANGSA
1218 2667 KLINIK & APOTEK KF 81JL. TM.ZEIN NO.1E
,LANGSA,ACEHTIMUR
SRI RIZKI MAULIZA
S.SI. APT.farmacy 0641-21020| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1219 2711 RS. CUT MEUTIAJL. GARUDA NO. 1 KEL. KEBON BARU
LANGSA ACEHIBU SUSI - (0641) 426285| - Y Y Y ACTIVE ALL COVERAGE [email protected]
LHOKSEUMAWE
1220 1975 KLINIK VINCA ROSEAJL. DARUSSALAM NO. 36 -
LHOKSEUMAWEBAPAK AZHARI - 0645-7011117 / 46725| 0645-630218 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1221 1892 RS. SAKINAH LHOKSEUMAWE JL. ANTARA NO 30, LHOKSEUMAWEBPK PADLI/ IBU
IDA/ BPK HERIMARKETING 0645-45534/42158| - Y N Y ACTIVE ALL COVERAGE [email protected]
1222 2119 APOTEK KIMIA FARMA 60JL. MERDEKA NO. 47 B -C
LHOKSEUMAWE BANDA ACEH
IBU SINTA
(APOTEKER)- 0645-41152| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
MEULABOH
1223 3686 RS. SWASTA MONTELLAJL. BERINGIN JAYA SAMPING MESJID
AGUNG, MEULABOH, ACEH BARAT
ROSI NURUL
SAPUANMARKETING
(0655) 7551974;
085277358711|- Y Y Y ACTIVE ALL COVERAGE [email protected]
BIMA
1224 3506 KIMIA FARMA NO. 263 BIMA JL. SOEKARNO - HATTA NO. 3 BIMA BP TAUFIK - 0374-42910| N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
LOMBOK TIMUR
1225 1894 RS. ISLAM NAMIRA SELONGJL. KH AHMAD DAHLAN NO 7. KEC
SELONG KOTA SELONGBAPAK DODDY - 0376-22693/21004/| - Y Y Y ACTIVE ALL COVERAGE [email protected]
MALUKU
MALUKU UTARA
NAD
NTB
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 45 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1226 3503 KIMIA FARMA NO. 55 SELONG
JL. M. YAMIN NO. 77 SELONG -
LOMBOK TIMUR- - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
MATARAM
1227 1957 RSIA. PERMATA HATI MATARAM JL. MAJAPAHIT NO 8Ibu Aam Rizky
AmaliaMarketing 0370-631999| 0370-632999 Y Y Y ACTIVE ALL COVERAGE
permatahatimaternityclinic@yah
oo.co.id1228 1958 RB. TRESNA JL. BUNG KARNO NO.28 DEWANTORO MARKETING 0370-637965/630478| - N Y Y ACTIVE ALL COVERAGE [email protected]
1229 2257 KLINIK & APOTEK KF NO 134 JL. PEJANGGIK NO. 48 MATARAM - - 0370-638502| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1230 1956 RSI. SITI HAJAR MATARAM JL. CATUR WARGA NO. 6 MATARAMIBU HJ ERNI/ IBU
NINING- 0370-623498| - Y Y Y ACTIVE ALL COVERAGE
[email protected];rsi_sitihaj
1231 1645 RS. HARAPAN KELUARGA MATARAM
JL. AHMAD YANI NO. 9 SELAGALAS,
SANDUBAYA, MATARAM - LOMBOK
(NTB)
SULMAN HIDAYAT MARKETING0370-
670000,6177027,6177000|0370-673666 Y Y Y ACTIVE ALL COVERAGE
d
1232 1124 RSB. EXONERO JL. PEMUDA NO.16, DASAN AGUNG IBU LUSI MARKETING 0370-636454,644440|0370-
647023/636454Y N Y ACTIVE ALL COVERAGE [email protected]
1233 3507 KIMIA FARMA CATUR WARGA JL. CATUR WARGA NO. 17 MATARAM - - -| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1234 3505 KIMIA FARMA NO. 234 MATARAM JL. SELAPARANG NO. 53 MATARAM - - -| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1235 3504 KIMIA FARMA NO. 231 MATARAM JL. SALEH SUNGKAR NO. 33 AMPENAN - - -| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1236 1827 RS. BIOMEDIKA JL. BUNG KARNO NO 143 MATARAM IBU GITHA MARKETING 0370-645137| 0370-645138 Y Y Y ACTIVE ALL COVERAGE [email protected]
1237 1539 RS. RISA SENTRA MEDIKAJL. PEJANGGIK, NO.115,
CAKRANEGARAIBU IKA MARKETING 0370-632117/625560/| 0370-625559 Y Y Y ACTIVE ALL COVERAGE [email protected]
1238 2258 KLINIK & APOTEK KF NO. 189 JL. SRIWIJAYA NO. 295 MATARAM - - 0370-633211| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
SUMBAWA
1239 3482 KIMIA FARMA NO. 303 SUMBAWA JL. CENDRAWASIH SUMBAWA BESAR - - 0371 - 24029| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
ENDE
1240 3500 KIMIA FARMA KELIMUTU ENDE JALAN KELIMUTU ENDEGLOCESDO TOGAR
HASIHOLAN TAMBA- (0381)-2627456| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
KUPANG
1241 3464 RS. WIRASAKTI JL. MOH. HATTA KUPANGI NYOMAN DESEL
ARIANTA-
(0380)-821131 / 0380-
824735|- Y Y Y ACTIVE ALL COVERAGE [email protected]
1242 2972 RS. KARTINI KUPANGJL. FRANS SEDA NO.17,KELURAHAN
TUAK DAUN MERAH, KUPANG-85228IBU SEPVIAN MARKETING 0380-80265111| (0380) 831270 Y Y Y ACTIVE ALL COVERAGE [email protected]
1243 1380 KLINIK & APOTIK KARTINI JL. ELTARI I NO.2 DR.IKE PENGELOLA 0380-833010| 0380-820660 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1244 1647 RSIA. DEDARIJL. RANTAI DAMAI 69 D TDM OEBUFU
KUPANG-NTT
BPK DEVA KETUT
WIRYAMARKETING 0380-8553914/826774|
0380-
830041/8553914Y Y Y ACTIVE ALL COVERAGE [email protected]
1245 2242 KLINIK & APOTEK KF 135 KUPANG JL. M. HATTA 46 KUPANG BPK. ANTON Apoteker0380-
830944/820541/831296|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
1246 2245 KLINIK & APOTEK KF 101 KUPANG JL. HEREWILA NO. 38 KUPANG SULFIANTO - 0380- 827270| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1247 2666 KLINIK & APOTEK KF LALAMENTIK JL. WJ.LALAMENTIK,95 D-E, KUPANGMARYANTO YOSEPH.
S.FARM, APT- 0380-840362| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1248 3975 SILOAM HOSPITALS KUPANGJL. RW MONGINSIDI RT. 014 RW. 004
FATUTULI
DR. VERONIKA
HANNY, MARS.MARKETING 0380-8530900/8530911| 0380-8530933 Y Y Y ACTIVE ALL COVERAGE
veronica.hanny@siloamhospitals.
com
1249 2240 RS. ST CAROLUS BORROMEUS JL. HR. KOROH KM. 08 BELLO KUPANGDR. HERLY
SOEDARMADJI- 0380 - 8030530| - Y Y Y ACTIVE ALL COVERAGE [email protected]
SIKKA
JAYAPURA
1250 1384 RS. TK.II MARTHEN INDEY JL. DIPONEGORO, NO.57KAPTEN GEDE
SATRIA WLAB
0967-
537735/5763479/532491|0967-537735 Y Y Y ACTIVE ALL COVERAGE [email protected]
1251 4203 LAB. KLINIK CITO JL. ARGAPURA NO. 11 E, JAYAPURA BPK MUHADI KOORDINATOR0967-522080 /
085244202002|0967-522082 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
NTT
PAPUA
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 46 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1252 2189 APOTEK KIMIA FARMA 194 JAYAPURA JL. AHMAD YANI NO. 29 BP. PERDANA
PENANGGUNG
JAWAB0967-533 322| 0967-533 322 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1253 2188 KLINIK & APOTEK KF 172 JAYAPURA JL. AHMAD YANI NO. 67,JAYAPURA CHRISTINA BAY AST. APOTEKER 0967-534921/533 322| 0967-534921 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1254 1469 RS. DIAN HARAPANJL. TARUNA BHAKTI KEL YABANSAI
DISTRIK HERANG - JAYAPURA
IBU JASINTA
ANASTASIA, AMDKabag Sekretariat 0967-572325|
0967-
573362/573979Y Y Y ACTIVE ALL COVERAGE
rumahsakitdianharapan@yahoo.
com
MERAUKE
1255 0904 RSUD. MERAUKE JL. SUKARJO WIRYOPRANOTO IBU YERMINA KEPALA TU 0971-321125|-0971-
321124/325906Y Y Y ACTIVE ALL COVERAGE
1256 1045 RS. BUNDA PENGHARAPAN JL. KELAPA LIMA ANGKASA NO. 1 SR.CLARA MARKETING 0971-325906|- 0971-323596 Y Y Y ACTIVE ALL COVERAGE [email protected]
1257 4213 LAB. KLINIK CITO MERAUKEJL. RAYA MANDALA 293, MERAUKE
PAPUAYUSUF PAREBONG - 0971-325367| 0971-325368 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
TIMIKA
1258 2716 RS. KASIH HERLINAJL. A. YANI NO. 37 TIMIKA PAPUA
99910Ibu Herlina Direktur (0901) 321433/321443| (0901) 324310 Y Y Y ACTIVE ALL COVERAGE [email protected]
1259 2732 KLINIK PURI HUSADAJL. BUDI UTOMO UJUNG, TIMIKA
PAPUABAPAK PARDI Owner
(0901)
3126661/081240760444|- N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
SORONG
1260 1716 RS. TNI AL DR R. OETOJO SORONGJL. AHMAD YANI, KLADEMAK III C,
SORONGIBU NUR -
0951-321946 / 0951-
323823|0951-323823 Y Y Y ACTIVE ALL COVERAGE
1261 1475 RS. PERTAMINA SORONG JL. AHMAD YANI NO. 13 IBU FEBI MARKETING 0951-321362, 321581| 0951-326110 Y Y Y ACTIVE ALL [email protected];
1262 1468 RS. MUTIARA SORONG JL. MALEO, NO. 2-A, SORONG.BPK. M. FARID
SOAMANGON-
0951-
327433/324593/332061|0951-327433 Y Y Y ACTIVE ALL COVERAGE [email protected]
DUMAI
1263 1621KLINIK RAWAT INAP & BERSALIN
PADU SERASI
JL. JEND. SUDIRMAN NO. 188 DUMAI,
RIAUYULIANI - 0765-438189 / 438289| 0765-438008 N Y Y ACTIVE ALL COVERAGE [email protected]
1264 2766 KLINIK IGA DUMAIJL. SUTAN SYARIF KASIM NO.221,
DUMAI - RIAUDR. GABY -
0765-4397481/
085264881796|N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
DURI
1265 0624 RSIA. MUTIA SARIJL. BATHIN BETUAH, NO.1-A, SIMPANG
PADANGBPK YAHYA MARKETING 0765-93635/92080|
0765-
597972/55979Y Y Y ACTIVE ALL COVERAGE [email protected]
1266 0921 RS. PERMATA HATI DURIJL. JEND SUDIRMAN NO.37 SIMPANG
PADANG
IBU INEL/ ROSSA/
RINCEMARKETING
0765-94902/95799,
GIGI913670765-0765-
596899|0765-0765-596899
0765-595799 Y Y Y ACTIVE ALL COVERAGE [email protected]
1267 0922 KLINIK THURSINAJL. JEND SUDIRMAN NO.65 SIMPANG
PADANGIBU ELMA MARKETING
0765-5955730765-
595573|0765-5955730765-595573 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1268 0930 RSU. THURSINA JL. HANGTUAH NO.93 IBU ELMA MARKETING0765-5977820765-
595573|0765-5955730765-597773 Y Y Y ACTIVE ALL COVERAGE
[email protected];belmanj
INDRAGIRI HILIR
1269 2302 RS. INDRAGIRIJL. TRIMAS NO. 77 TEMBILAHAN
INDRAGIRI HILIR - RIAUBPK. ARS. YAD Marketing 0768-23555| 0768-21539 Y Y Y ACTIVE ALL COVERAGE [email protected]
PANGKALAN KERINCI
1270 1369 RS. EFARINA PANGKALAN KERINCIJL. LINTAS TIMUR NO 1, PANGKALAN
KERINCI, KAB PELALAWANIBU ERVINA - 0761-494500/493980| 0761- 493981 Y Y Y ACTIVE ALL COVERAGE [email protected]
PEKANBARU
1271 1535 EKA HOSPITAL PEKANBARU JL. SOEKARNO HATTA, KM.6,5BPK. AANNUR/IBU
ITAMARKETING 0761-6989999| 0761-6989944 Y Y Y ACTIVE ALL COVERAGE
m
1272 0920 RS. AWAL BROS PEKANBARU JL. JEND SUDIRMAN NO.117 BP RONI ISWANDI MARKETING 0761-47333-|- 0761-47222 Y Y Y ACTIVE ALL [email protected]/marketi
1273 2101 APOTEK KIMIA FARMA 229 JL. SUDIRMAN 724 PEKANBARU MACHALI APOTEKER 0761 29186| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1274 2102 KLINIK & APOTEK KF 93 PEKANBARUJL. JEND. SUDIRMAN NO 175
PEKANBARUAMINULHAM - 0761-32796| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1275 1596RS. KHUSUS BEDAH & KEBIDANAN
SYAFIRA
JL. JEND.SUDIRMAN NO.134
PEKANBARUIBU.TITIN MARKETING 0761-856517,35360| 0761-41887 Y Y Y ACTIVE ALL COVERAGE
info@rs-
syafira.com/babbynikicio@ymail.
com
1276 1444 RS. LANCANG KUNING JL. RONGGOWARSI. TO UJUNG, NO.5A IBU JUMI / IBU NIA MARKETING 0761-859273/859274| 0761-34672 Y Y Y ACTIVE ALL COVERAGE [email protected]
1277 0841 RSIA. ZAINAB JL. RONGGOWARSI. TO I NO.1 BPK. JANUAR MARKETING 0761-24000| 0761-859448 Y Y Y ACTIVE ALL COVERAGE [email protected]
RIAU
PAPUA BARAT
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 47 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1278 0664 RS. ISLAM IBNU SINA PEKANBARU JL. MELATI, NO.60ZACKY FAISAL/ IBU
FARAHHUMAS 0761-24242/26011| 0761-35698 Y Y Y ACTIVE ALL COVERAGE [email protected]
1279 0791 RS. PEKANBARU MEDICAL CENTERJL. LEMBAGA PEMASYARAKATAN
NO.25,GOBAH
DR. ZUL INDRA/IBU
FEBRI/BPK ADRIANMARKETING 0761-848100/859510| 0761-859510 Y Y Y ACTIVE ALL COVERAGE [email protected]
1280 0625 RS. SANTA MARIA PEKANBARU JL. A. YANI, NO.68IBU KANTI /
FRANSISKAHUMAS
0761-
28800,20235,20166,22213|0761-26071 Y Y Y ACTIVE ALL COVERAGE
[email protected]/fransisika@
yahoo.com
1281 2926 RSIA. ANDINIJL. TUANKU TAMBUSAI NO.55,
PEKANBARUDR WILMI / LINA - (0761) 33612| (0761) 33649 Y Y Y ACTIVE ALL COVERAGE
1282 4134 RS. PROF.DR.TABRANI JL.JEND. SUDIRMAN NO. 410 IBU AYU MARKETING 0761-35464| 0761-839114 Y Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1283 2837KLINIK MATA SUMATERA EYE
CENTER PEKANBARUJL. ARIFIN AHMAD NO. 58 PEKANBARU IBU ENI PIC 0761-565686| 0761-565786 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
smec_pekanbaru@smec-
group.com
1284 3003 PRAKTEK DRG. TENSY A. TJL. AHMAD YANI 111C ( APOTEK
PANGEAN ) PEKANBARUBAPAK BENNY -
081365910510 ;
081364223894|- N Y Y PARTIAL DENTAL
1285 0663 RSIA. ERIA BUNDA JL. KH. AHMAD DAHLAN, NO.163IBU TETTI
ROZA/EFAKEUANGAN 0761-23100/23600| 0761-47235 Y Y Y ACTIVE ALL COVERAGE [email protected]
1286 2409 RSIA. BUDHI MULIAJL.SOEKARNO HATTA NO.226-228
ARENGKA, PEKANBARUISMAIDA MARKETING 0761-3069900/8417200| 0761-8417255 Y Y Y ACTIVE ALL COVERAGE
m
1287 2590 RSB. ANNISA TANGKERANGJL. GARUDA NO. 66 TASKURUN UNJUNG
TANGKERANG TENGAH, PEKANBARURIO - (0761) 848 652| (0761) 848 652 Y Y Y ACTIVE ALL COVERAGE
marketingrsbersalinannisa@gmai
l.com
1288 2468 RS. AWAL BROS PANAM
JL. HR. SOEBRANTAS RT. 01/RW. 03
NO 88 KEL. TUAH KARYA KEC. TAMPAN
PANAM, PEKANBARU
DR CACA BUSSNISE DEV 0761-586 888| 0761 586111 Y Y Y ACTIVE ALL COVERAGE [email protected]
ROKAN HILIR
1289 2199 KLINIK AGUNGJALAN JEND. SUDIRMAN KM. 8, BAGAN
BATU - ROKAN HILIR - RIAU- - 0765-552459| 0765-552459 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
ROKAN HULU
1290 1878 RS. AWAL BROS UJUNG BATUJL. JEND. SUDIRMAN NO. 314 UJUNG
BATU ROKAN HULU RIAUELISA marketing 0762-7363329| 0762-7363334 Y Y Y ACTIVE ALL COVERAGE [email protected]
BATAM1291 0584 RS. AWAL BROS BATAM JL. GAJAH MADA KAV.1 BALOI IBU MARIA MARKETING 0778 - 431777| 0778-430777 Y Y Y ACTIVE ALL COVERAGE [email protected]
1292 0484 RB. BUDI ROSARIJL. MAHKOTA SIMPANG, NO.1,
BENGKONG MAHKOTA
BPK WIRA / IBU
NENENGKEUANGAN 0778-427854| 0778-432833 N Y Y ACTIVE ALL COVERAGE [email protected]
1293 1010 RS. ST. ELISABETH - BATAM JL. ANGGREK BLOK II, BALOIIBU PURNAMA/ IBU
MARIA
KEUANGAN/MARKE
TING0778 - 457357-|-
0778-
457710/422473Y Y Y ACTIVE ALL COVERAGE [email protected]
1294 0485 GENTA MEDICAL CENTER MUKA KUNING INDAH, BLOK F, NO.10 IBU LINDAPELAYANAN
PASIEN0778-361909| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
1295 0764 RS. HARAPAN BUNDA BATAM JL. SERAYA NO.1IBU NORA /
ARISTONMARKETING
0778-
457333/456444/458808077
8 - 458808|0778 - 458808
0778-456800 Y Y Y ACTIVE ALL [email protected]/n
1296 2448YAHYA MEDICAL CENTER & APOTIK
ZAHRUNI
KOMPLEK RUKO SAGULUNG PERMAI
BLOK B14-15, SAGULUNG KOTA,
BATAM
HAMDANI HRD (0778) 392748| (0778) 392749 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1297 2479 KLINIK & APOTEK KF 413KOMP. RUKO BOTANIA GARDEN BLOK A
1 NO. 1 C - BATAMDARMA, S.FARM Kepala Apotik 0778 7431199| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1298 2480 KLINIK & APOTEK KF 128KOMP. PERTOKOAN WIJAYA BLOK A NO.
4 SEI HARAPAN - BATAM
ROSMIDA KHOHAR,
S.SI- 0778 323697| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1299 2482 KLINIK & APOTEK KF 269JL. JEND SUDIRMAN, BATAM CENTRE,
BATAM
DRS. HERMANTA
TARIGAN- 0778 461482| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1300 2484 KLINIK & APOTEK KF 59JL. IMAM BONJOL, NO.1, NAGOYA,
BATAM
DRS. I KOMANG
KARTIKA YASA- 0778 458560| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1301 2486 KLINIK & APOTEK KF 137KOMP.SAGULUNG MAS INDAH B3,
BATAM
B. AGUNG WIDI N,
S.SI- 0778 392146| - N Y Y PARTIAL H&S,MAT -
1302 2503 RS. GRAHA HERMINEKOMP. RUKO ASIH RAYA NO.9-15,
BATU AJIFITRI - (0778) 363318, 363127| (0778) 363164 Y Y Y ACTIVE ALL COVERAGE [email protected]
1303 2487 KLINIK & APOTEK KF 224KOMP MUKA KUNING INDAH II B2.3,
BATAM
ADHLIN YULSYAR,
S.FARM- 0778 363375| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1304 4150 KLINIK & APOTEK KF NO. 230 PANBIL MALL BLOK A NO. 5
DRA. ITA
TAURIESTANINGTYA
S, Apt
- 0778-371149| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
BINTAN
RIAU KEPULAUAN
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 48 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1305 1240 RB. & BP TIARA MEDIKA
JL. KAMPUNG HARAPAN RT 01/01
TELUK SASAH, TANJUNG UBAN
DR.ERIKA KAMIL/
IBU OJIPEMILIK/ ADM 0771-484427| 0771-484427 Y Y Y PARTIAL
GP,SP,OP,DENTAL,MAT,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
1306 1241 KLINIK BERSALIN ERNES JL. PERMAISURI NO.8 TANJUNG UBANDR.ODRI AGNES/
IBU INDRAACOUNTING 0771-483212| 0771-482738 Y Y Y ACTIVE ALL COVERAGE [email protected]
BINTAN UTARA
1307 2457 RSUD. TANJUNG UBANJL. INDUN SURI SIMPANG BUSUNG
NO.1 TANJUNG UBAN 29152
RANTI/ BPK IYAN
GUMILANGHUMAS
(0771) 482655/
082324421982|- Y Y Y ACTIVE ALL COVERAGE [email protected]
KARIMUN
1308 1271 RS. BAKTI TIMAH KARIMUN
JL. CANGGAI PUTRI TELUK UMA
KABUPATEN KARIMUN PROVINSI
KEPULAUAN RIAU 29661
IBU SERLY MARKETING 0777-7367085| 0777-7333251 Y Y Y ACTIVE ALL COVERAGE [email protected]
1309 1291 APOTIK DEVI FARMAJL. AHMAD YANI, SEI PASIR, MERAL,
TANJUNG BALAIBPK.RACHMADI PEMILIK 0777-21388|
0777-
368974/21388N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1310 0874 RSB. GRAHA RAPJL. R.USMAN, BATU LIPAI, TANJUNG
BALAIDR.RIDWAN A. PEMILIK 0777-325600,326097| 0777-323857 Y Y Y ACTIVE ALL COVERAGE [email protected]
1311 1237 KLINIK SAYANG IBUJL. AHMAD YANI, NO.20, BARAN SATU,
MERAL, TANJUNG BALAI
DR.AWANG LIM /
IBU ELIPEMILIK 0777- 216 76| 0777- 222 52 N Y Y ACTIVE ALL COVERAGE [email protected]
TANJUNG PINANG
1312 2483 KLINIK & APOTEK KF 31 JL. BINTAN 656-658,TG.PINANGM. TRI KURNIAWAN,
S.SI- 0771 22879, 21091| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
-
m
MAMUJU
1313 4087 RSUD. MAMUJUJL. RE. MARTADINATA MAMUJU -
SULBAR
DR. H. HARMAN
HABADirektur 0426-21107| - Y Y Y ACTIVE ALL COVERAGE [email protected]
MAKASSAR
1314 2657 KLINIK & APOTEK KF HERTASNING JL. HERTASNING NO 11 - MAKASSARDRS. ROY
MUSTAKIM, APT.- 0411- 442945| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1315 1630 RS. AWAL BROS MAKASSARJL. JEND. URIP SUMOHARJO NO.43
MAKASSAR
IBU. INDAH SARI
MAHMUDMARKETING 0411-454567/452725|
0411-
459288/455123Y Y Y ACTIVE ALL COVERAGE [email protected]
1316 0644 RS. HIKMAH JL. YOSEF LATUMAHINA NO.1 IBU HERLINA MARKETING0411 - 872284,8714030411-
871403|0411-871403
0411 -
870964,871403Y Y Y ACTIVE ALL COVERAGE [email protected]
1317 1393 RSIA. SITI KHADIJAH 1 MAKASSAR JL. KARTINI NO.15-17 MAKASSARIBU FITRI/
MUBARAQMarketing 0411-3624554/8614661| 0411-3627119 Y Y Y ACTIVE ALL COVERAGE [email protected]
1318 1390 RS. IBNU SINA YBW-UMI JL. URIP SUMOHARJO, KM.5, NO.264 DR.DAHLIAH PELAYANA MEDIS0411-
452958/5781595/452917|0411-425397 Y Y Y ACTIVE ALL COVERAGE [email protected]
1319 1389 RS. GRESTELINA JL. LETJEN HERTASNING RAYA NO.51DR. BENHARD
KATUUK, IBU LILIKMARKETING 0411-448855/448852| 0411-448854 Y Y Y ACTIVE ALL COVERAGE [email protected]
1320 1388 RATULANGI MEDICAL CENTRE JL. SAM RATULANGI NO.28 IBU YURIKE MARKETING 0411-878605/06/88| 0411-878587 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
1321 2717 KLINIK & APOTEK KF 38 JL. HASANUDDIN, NO.46, MAKASSARDRS. YUNI ASMAN,
APT.- 0411- 3617110| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1322 2661 KLINIK & APOTEK KF 250 JL. DR.RATULANGI 59, MAKASSARDRS. FAEDAL B.,
APT.- 0411- 582895| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1323 2660 KLINIK & APOTEK KF DAENG TATA JL. DAENG TATA 69, MAKASSARDRS. ROY
MUSTAKIM, APT.- 0811403255| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1324 2659 KLINIK & APOTEK KF PETTARANI JL. PETTARANI 18, MAKASSARDRS. ROY
MUSTAKIM, APT.- 0411-857210 / 857215| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1325 2658 KLINIK & APOTEK KF 33JL. AHMAD YANI, NO.17 - 19,
MAKASSAR
DRS. ROY
MUSTAKIM, APT.- 0411-3616722| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1326 0641 RS. STELLA MARIS MAKASSAR JL. SOMBA OPU NO.273, PO.BOX 122IBU CHRISTINA/IBU
DEVIKERJASAMA 0411-871391/873346| 0411 - 859545 Y Y Y ACTIVE ALL COVERAGE
marketing@rsstellamari
1327 2178 APOTEK FARMARIN MAKASSARJL. SAMRATULANGI NO. 51 D
MAKASSAR
DRS. DAUD MANDI,
APT- 0411-877551/ 0811414971| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1328 1847 SILOAM HOSPITALS MAKASSAR
JL. METRO TANJUNG BUNGA KAV. 9
PANAMBUNGAN KEC. MARISSO -
MAKASAR
PUTRI AMELIA BUSDEV MANAGER
0411-
8117555/8117430/5290000
/3662900|
0411-8117911 Y Y Y ACTIVE ALL [email protected]
m
1329 3085 RS. UNIVERSITAS HASANUDDINJL. PERINTIS KEMERDEKAAN KM.11
MAKASSAR 90245IBU MIRNA - 0411 - 591331| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1330 3065 RSB. SENTOSA MAKASSAR JL. JEND. SUDIRMAN 52,IBU FRIESYE
(081342580333)marketing 0411-3612720| (0411) 3619711 Y Y Y ACTIVE ALL COVERAGE [email protected]
SULAWESI BARAT
SULAWESI SELATAN
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 49 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1331 2291 KLINIK & APOTEK KF 199 ERLINA
JL. URIP SUMOHARJO NO. 32
MAKASSAR- - 0411 449 936| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
PALOPO1332 0914 RS. AT MEDIKA JL. ANDI JEMMA, NO.09 AMRULLAH - 0471-21596-|- 0471-23008 Y Y Y ACTIVE ALL COVERAGE [email protected]
1333 2107 RS. BINTANG LAUT JL. K HM KASYIM NO. 5 PALOPO IBU TANTI MARKETING 0471-21302/21059| - Y Y Y ACTIVE ALL [email protected]
d
PARE PARE
1334 1394 RS. FATIMA PARE-PARE JL. ILHAMV KOTAK POS 12IBU IDA / IBU
MERRYMARKETING 0421-21847| 0421-21328 Y Y Y ACTIVE ALL COVERAGE [email protected]
SENGKANG
PALU
1335 0639RSU. WOODWARD (BALA
KESELAMATAN)JL. LH. WOODWARD NO.1 BPK.FREDIK MARKETING 0451 - 421769, 423744| 0451 - 423744 Y Y Y ACTIVE ALL COVERAGE
1336 2288 KLINIK & APOTEK KF 390 PALUJL. SETIABUDI NO. 65 D PALU
SULTENG- - -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1337 2287 APOTEK KIMIA FARMA 449 TATURAJL. WOLTER MONGINSIDI NO. 145
PALU, SULTENGBP MUSLIM - 0451-429832| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
BAU BAU
1338 2300 RS. MURHUM
JL. SULTAN MURHUM NO. 69 KEL.
WAJO KEC. MURHUM SULTENG, BAU
BAU
BP H FUAZI - 0402-2822650| 0402-2823919 Y Y Y ACTIVE ALL COVERAGE -
KENDARI
1339 1537 RS. ST. ANNA JL. DR. MOH.HATTA, NO.65A BPK.MATIUS MARDI KEUANGAN 0401-3123092| 0401-3124872 Y Y Y ACTIVE ALL COVERAGE [email protected]
1340 2286 KLINIK & APOTEK KF 288 JL. A. YANI NO. 84 KENDARI Firdaus - 0401 319 6186| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1341 2285 APOTEK KIMIA FARMA 104JL. MOH. HATTA NO. 77 KENDARI
93124Darlin - 0401 3127182| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
KOTAMOBAGUMANADO
1342 1798 SILOAM HOSPITALS MANADO JL. SAM RATULANGI NO 22 MANADOBP. SELFIANUS /
IBU FRANSIENMARKETING
0431-
8883180/8883131/8883911
|
0431-8883133 Y Y Y ACTIVE ALL COVERAGEselfianus.runtu@siloamhospitals.
com
1343 2805 RSIA. KASIH IBU MANADOKOMPLEKS BAHU MALL BLOCK. C NO.
23) JL. N. WOLTER MONGINSIDI NO. 1ibu Jane marketing 0431 834780/834667| 0431 834721 Y Y Y ACTIVE ALL COVERAGE [email protected]
1344 2230 KLINIK & APOTEK KF NO. 74JL. SAM RATULANGI NO.31 MANADO
93117BPK RIDWAN - 0431-864012| 0431-850838 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1345 2232 KLINIK & APOTEK KF WENANG 309JL. LIMIMUNT NO. 12 A KEL. TIKALA
KUMARAKA, KEC. WENANG, MANADO
BPK RUDI
AVIANSYAH- 0431-867163/840087| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1346 2231 APOTEK KIMIA FARMA MALALAYANG KP. REL NO. 5 RS. VP MALALAYANGBPK DUDI
ABDULRAHMAN- 0431-838278| 0431-838277 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1347 1502 RS. ADVENT MANADO JL. 14 FEBRUARI, NO.1, TELING ATAS BP MODI MAMAHID MARKETING 0431-847950/858429| 0431-850012 Y Y Y ACTIVE ALL COVERAGE [email protected]
BUKIT TINGGI
1348 2114KLINIK & APOTEK KF 146 BUKIT
TINGGI
JL. JEND. SUDIRMAN NO 14 BUKIT
TINGGI- - -| - N Y Y PARTIAL
H&S,GP,SP,OP,DENTAL,LAB,RM-
RI,RM-RJ,RM-RG,RM-KM,RM-
RB,PHAR
-
1349 1398 RSU. MADINA JL. GURU HAMZAH NO.17 BPK.JOHN HENDRI Medical Record 0752-21388 EXT 228| 0752-626677 Y Y Y ACTIVE ALL COVERAGE [email protected]
1350 0687 RS. ISLAM IBNU SINA BUKIT TINGGI JL. BATANG AGAM, BELAKANG BALOK IBU DEWI MARKETING 0752 - 21185| 0752-34009 Y Y Y ACTIVE ALL COVERAGE [email protected]
PADANG
1351 1569 RSIA. CICIKJL. DR. SUTOMO NO.94 MARAPALAM
PADANG 25125BPK. FARDINA MARKETING (0751) 38846; 38866| (0751) 841286 Y Y Y ACTIVE ALL COVERAGE [email protected]
1352 0616 RS. YOS SUDARSO JL. SITUJUH, NO.1 IBU HELEN MARKETING 0751-33230/33231| 0751-31811 Y Y Y ACTIVE ALL COVERAGE [email protected]
1353 0423RSU. BUNDA MEDICAL CENTER (RSU.
C-BMC)JL. PROKLAMASI NO.31-33-37 PADANG BPK ADRIAN MARKETING
0751-
23164/29536/21151/24750|0751-23200 Y Y Y ACTIVE ALL COVERAGE [email protected]
1354 2714 SEMEN PADANG HOSPITALJL. BY PASS KM 7 KEL. PISANG, KEC.
PAUH PADANG - SUMBAR
DR. MISS
BERLYANTI-
(0751) 777888, 4782999.,
4782997|(0751) 4782990 Y Y Y ACTIVE ALL COVERAGE
1355 0304 RS. SELAGURI JL. A.YANI, NO.26 IBU FAYNEM MARKETING 0751 -33010/21953| 0751-840051 Y Y Y ACTIVE ALL COVERAGE [email protected]
1356 1320 RSI. SITI RAHMAH PADANGJL. RAYA BY PASS KM 15 AIE PACAH,
PADANGIBU YORI -Marketing 0751-463059| 0751-463531 Y Y Y ACTIVE ALL COVERAGE [email protected]
SULAWESI TENGAH
SULAWESI TENGGARA
SULAWESI UTARA
SUMATERA BARAT
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 50 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1357 2369RS. MATA PADANG EYE CENTER
(PEC)JL. PEMUDA NO. 53 PADANG - SUMBAR SDR. SILVIA - 0751-30094| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1358 4070 RSIA. ANNISA PADANG JL. PEMUDA NO. 18, PADANG IBU MAI ZURYATI MARKETING (0751) 31906| (0751) 31905 Y Y Y ACTIVE ALL COVERAGE [email protected]
1359 4051 RSIA. SITI HAWA JL. PARAK GADANG RAYA NO.35 IBU ENDANG Marketing 0751-841251| - Y Y Y ACTIVE ALL COVERAGE [email protected]
1360 2060 KLINIK & APOTEK KF 94 PADANG JL. PROKLAMASI N. 24 PADANG RONI KA-HUMAS 0751-891195| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1361 2113 KLINIK & APOTEK KF 238 PADANG JL. PATIMURA NO 18 PADANG AHMAD SYAHRONI - 0751-23620| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
PAYAKUMBUH
1362 2115KLINIK & APOTEK KF 372
PAYAKUMBUHJL. JEND. SUDIRMAN PAYAKUMBUH JUNIARTI apoteker -| KF_ N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR
TEBING TINGGI
BATU RAJA
1363 1284 RS. SANTO ANTONIOJL. KOMISARIS UMAR NO. 33,
BATURAJASR. M. SKOLASTIKA HUMAS
0735-
320395/322418/324700|0735-320201 Y Y Y ACTIVE ALL COVERAGE [email protected]
DELI SERDANG
1364 3994 RS. SARI MUTIARA LUBUK PAKAMJL. MEDAN NO.17 LUBUK PAKAM
SUMUT
MELKY
TAMPUBOLONMARKETING (061) 7951339| (061) 7951344 Y Y Y ACTIVE ALL COVERAGE [email protected]
LUBUK LINGGAU
1365 2715 RS. AR BUNDA LUBUK LINGGAU
JL. GARUDA NO 245 RT 03 KEL.
BANDUNG KIRI, KEC. LINGGAU BARAT
1
- - (0733) 324955/324963| (0733) 321892 Y Y Y ACTIVE ALL COVERAGE [email protected]
1366 1869 KLINIK SEKATAJL. YOS SUDARS. O NO. 230 TABAH
JEMEKEH, LUBUK LINGGAU
DR CHRISTANTO
BEKTI PRASETYOKoordinator dokter 0733-321357| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PALEMBANG
1367 2839 POLIKLINIK PERTAMINA PALEMBANGJL. JEND. AHMAD YANI NO. 1247. 1
PALEMBANGDR. MAHARANI penanggung jawab -| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,PHAR-
1368 0817 RS. RK. CHARITAS JL. JEND. SUDIRMAN NO.1054
BPK.AGUSMAN/ZR.E
MI/JUANDI JAYA
KOSIM
MARKETING0711-350426/3533750711-
353374/5|0711-353374/5
0711-
362205/377088Y Y Y ACTIVE ALL COVERAGE
1369 0803 RS. MYRIAJL. KOL. H. BURLIAN KM. 7 NO 228
PALEMBANGCHRISTIN MARKETING
0711-
411610/412433/421914|0711-414052 Y Y Y ACTIVE ALL COVERAGE
1370 0885 RSIA. YK. MADIRAJL. JEND SUDIRMAN NO.1051 C-D
PALEMBANGIBU SUKMA MARKETING
0711-364954,362766,
374802, 3747850711-
356173|0711-356173
(0711) 356173 Y Y Y ACTIVE ALL COVERAGE [email protected]
1371 0627 RS. PUSRI JL. MAYOR ZEN, KOMPLEK PUSRI NO. 1 BPK ROSMAN MARKETING 0711 -712222-712111| 0711-712071 Y Y Y ACTIVE ALL [email protected]/rumkit@
pusri.co.id
1372 0688RS. ISLAM SITI KHADIJAH
PALEMBANG
JL. DEMANG LEBAR DAUN, LORONG
PAKJO
IBU NALA RESMINI /
BPK ARISHUMAS 0711-356008| 0711-311884 Y Y Y ACTIVE ALL COVERAGE
rsisitikhadijahpalembang@yahoo
.co.id
1373 0883 RS. BUNDA PALEMBANG JL. DEMANG LEBAR DAUN, PALEMBANG TEGUH / ERNITAWADIR /
MARKETING
0711-312866,3118660711-
311866|0711-3118660711-355553 Y Y Y ACTIVE ALL COVERAGE [email protected]
1374 1622 RS. HERMINA PALEMBANG
JL. BASUKI RAHMAT NO.897
RT.011/003 KEL.20 ILIR II
KEC.KEMUNING
DR. EVA MARKETING 0711-352525| 0711-366945 Y Y Y ACTIVE ALL COVERAGEpalembang@herminahospitalgru
op.com
1375 1642 RS. PELABUHAN PALEMBANGJL. MAYOR MEMET SASTRAWIRYA NO 1
BOOM BARU PALEMBANG
IBU SELVY/ BP
HAMIDMARKETING
0711-
711843,712840,712916,719
741|
0711-717100 Y N Y ACTIVE ALL [email protected];rsp
1376 1884 SILOAM SRIWIJAYA PALEMBANGJL. POM IX KEL. LOROK PAKJO KEC.
ILIR BARAT 1 PALEMBANGIBU DEBBY / HANNY MARKETING 0711-5229100| 0711-5649100 Y Y Y ACTIVE ALL COVERAGE
om
1377 2787 RS. PERTAMINA PLAJU PERTAMEDIKA
JL. BERINGIN NO.1 KOMPLEK
PERTAMINA PLAJU SUMATERA SELATAN
30268
BPK AMAL - (0711) 597401| (0711) 542388 Y Y Y ACTIVE ALL COVERAGE [email protected]
1378 3965 RS. SRIWIJAYA EYE CENTERJL. JEND.SUDIRMAN KM. 4,5 NO.502
KEL. 20 ILIR, KEC. IT IIBU NITA MARKETING (0711) 5611976/419680| Y Y Y ACTIVE ALL COVERAGE
sriwijayaeyecentre.hospital@yah
oo.com
1379 2185 KLINIK & APOTEK KF 209 JL. ISKANDAR MUDA NO. 222BPK. UNDIANTO (BM
PALEMBANG)- 0711354717/0711362245| - N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1380 2423 RSIA. AZZAHRAJL. BRIGJEN HASAN KASIM NO.1-2
BUKIT SANGKAL PALEMBANGIBU.KIKI MARKETING 0711-822723| 0711-826044 Y Y Y ACTIVE ALL COVERAGE -
1381 2394 KIMIA FARMA 239 PALEMBANG JL. MP. MANGKUNEGARA, PALEMBANG BPK. AMIR - 0711 - 823503| - N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
PRABUMULIH
1382 1449 RS. AR BUNDA PRABUMULIHJL. ANGKATAN 45, KEL GUNUNG IBUL
PRABUMULIH TIMURIBU MARTINI MARKETING 0713-322954, 7003330|
0713-
325980/322954Y Y Y ACTIVE ALL COVERAGE
SUMATERA SELATAN
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 51 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1383 3953 RS. FADHILAHJL. JENDRAL SUDIRMAN NO. 01 PATIH
GALUNG PRABUMULIHIBU PUJI RAMADIN - (0713) 3300032| (0713) 3300032 Y Y Y ACTIVE ALL COVERAGE [email protected]
1384 0824 RS. PERTAMINA PRABUMULIHJL. KESEHATAN, NO.100, KOMPLEK
PERTAMINA PRABUMULIHIBU SULASMI/ AYU MARKETING
0713-
383333/382749/322069/38
2742/382731(0713)
382731|(0713) 382731
0713-
321903/325181Y Y Y ACTIVE ALL COVERAGE [email protected]
ASAHAN
1385 2351 RS. SETIO HUSODOJL. S. M. RAJA N0 67 KISARAN,
ASAHAN SUMATERA UTARABPK. AMIN - 0623-44999| 0623-43394 Y Y Y ACTIVE ALL COVERAGE [email protected]
BINJAI
1386 1811 RS. BIDADARI BINJAIPERINTIS KEMERDEKAAN NO 174 A
KEBUN LADA KOTA BIJAIIBU RINI - 061- 8830003| 061 - 8826004 Y Y Y ACTIVE ALL COVERAGE [email protected]
1387 1652 RS. LATERSIAJL. SOEKARNO HATTA, KM.18 NO.451,
BINJAIIBU ENDANG MARKETING 061-8829588/8829788| 061-8822565 Y Y Y ACTIVE ALL COVERAGE [email protected]
1388 1624 RSU. ARTHA MEDICA JL. SAMANHUDI NO. 22 BINJAI SRI HARNI MUKTI - 061-8827277| 061-8830757 Y Y Y ACTIVE ALL [email protected] ;
BRASTAGI
1389 1542 RS. EFARINA ETAHAM BRASTAGI JL. JAMIN GINTING, NO.1, DESA RAYA,
BPK.YAHYA
SEMBIRING/IBU
ELFINA
MARKETING 0628-323716/17| 0628-213718 Y Y Y ACTIVE ALL COVERAGE [email protected]
DELI SERDANG
1390 4088 RS. HIDAYAH DELI TUA JL. MEDAN DELI TUA KM 8,5 NO.55 DEVI MARKETING 061 - 7032835| - Y Y Y ACTIVE ALL COVERAGE [email protected]
KISARANLANGKAT
1391 1653RS. PERTAMINA PANGKALAN
BRANDAN
JL. WAHIDIN NO.01 PANGKALAN
BRANDAN LANGKAT-SUMUTIBU TETI PEMASARAN 0620-322612,322455| 0620-323392 Y Y Y ACTIVE ALL COVERAGE [email protected];
LUBUK PAKAM
1392 2023 RS. GRAND MEDISTRA LUBUK PAKAMJL. RAYA MEDAN-LUBUK PAKAM KM 25
NO. 66BPK LUKMAN
HUMAS
MARKETING061-7955114| 061-7950114 Y Y Y ACTIVE ALL COVERAGE [email protected]
MEDAN
1393 2754 RS. DELI JL. MERBABU NO.18-20, MEDANIBU TINA / DR. EKA
PUTRA- (061) 4565229| (061) 4552361 Y Y Y ACTIVE ALL COVERAGE [email protected]
1394 3957 RS. ROYAL PRIMA MEDANJL. AYAHANDA NO. 68 A, MEDAN -
SUMATERA UTARAIBU NOVI/ROMA MARKETING
(061) 8881 3182; 8881
3183|(061) 8001 3181 Y Y Y ACTIVE ALL COVERAGE [email protected]
1395 0416 RS. MATERNA JL. TEUKU UMAR NO.11 IBU BUNI / IBU UUT MARKETING 061 -4514222| 061-4155392 Y Y Y ACTIVE ALL COVERAGE [email protected]
1396 0773 RSU. PROF.DR.BOLONI JL. W. MONGINSIDI NO. 11 MEDAN JUWITA/ROULINA MARKETING/KEU(061) 4512687; 4556879;
4154637|(061) 4154621 Y Y Y ACTIVE ALL COVERAGE [email protected]
1397 0590RS. COLUMBIA ASIA MEDAN (D/H
GLENI MEDAN)JL. LISTRIK 2A MEDAN 20112 IBU IDHA HIDAYATI MARKETING 061-4566368|
061-
4566585/4515453Y Y Y ACTIVE ALL COVERAGE
marketing.medan@columbiaasia
.com
1398 0523 RS. ADVENT MEDAN JL. GATOT SUBROTO, KM. 4 BP ANDRI TOMPUL MARKETING 061 - 4524875/4574025| 061-4154839 Y Y Y ACTIVE ALL COVERAGE [email protected]
1399 0418 KLINIK SPESIALIS BUNDA JL. SISINGAMANGARAJA NO.17IBU DELI NAFRI/IBU
LISMAINIMARKETING 061 -7321666| 061-7344786 N Y Y ACTIVE ALL COVERAGE
[email protected]/apriyenn
1400 0925 RS. ST ELISABETH - MEDAN JL. H. MISBAH NO.7, MEDAN JUNIAR SINAGA SEKERTARIS
061-
4144737/4522010/4144240
|
061 - 4143168 Y Y Y ACTIVE ALL COVERAGE [email protected]
1401 0742 RSU. MARTHA FRISKAJL. KOL. YOS SUDARS. O KM.6, NO.91,
PULO BRAYAN
IBU VERONIKA/
MAYA/ ERLIANA
CUSTOMER
SERVICE061-6610910| 061-6612005 Y Y Y ACTIVE ALL COVERAGE [email protected]
1402 1193 RSU. SARAH JL. BAJA RAYA NO. 10 PETISAH IBU YANTI MARKETING 061-4528044| 061-4529454 Y Y Y ACTIVE ALL [email protected];
1403 1061 RS. ESTOMIHIJL. SISINGAMANGARAJA NO.235
MEDANIBU ELIS MARKETING
061-7861771,7864656061-
7864656|061-7864656061-7866660 Y Y Y ACTIVE ALL COVERAGE [email protected]
1404 0741 RS. ISLAM MALAHAYATI JL. DIPENOGORO NO.2-4, MEDAN IBU ADE Marketing 061 - 4518766| 061-4519474 Y Y Y ACTIVE ALL COVERAGE [email protected]
1405 0740 RS. HERNA JL. MAJAPAHIT NO.118A, MEDAN IBU HERLINA MARKETING061 -451 0766|IBU HENI/DR
LIMENTA061-415 3955 Y Y Y ACTIVE ALL COVERAGE [email protected]
1406 1592 RSIA. STELLA MARIS MEDAN JL. SAMANHUDI NO.20 MEDAN IBU HALINA Bag. Finance 061-4158383| 061-4157088 Y Y Y ACTIVE ALL COVERAGE [email protected]
1407 0322 RSU. PERMATA BUNDA MEDAN JL. SISINGAMANGARAJA, NO.7IBU FAUZIAH /
ADIST / RANIMARKETING
061-7362777 / 7360120 /
7367980 EXT. 141|061-7320222 Y N Y ACTIVE ALL COVERAGE [email protected]
1408 0626 RS. SARI MUTIARA JL. KAPTEN MUSLIM, NO.79 IBU KIKI MARKETING 061-8451812| 061-8452134 Y Y Y ACTIVE ALL COVERAGE [email protected]
1409 1649 RS. IMELDA PEKERJA INDONESIAJL. BILAL NO 24 PULO BRAYAN DARAT
I MEDAN TIMURIBU MARIA MARKETING 061-6610072-6631380| 061-6618457 Y Y Y ACTIVE ALL COVERAGE [email protected]
1410 1651 RS. BUNDA THAMRIN MEDANJL. SEI BATANG HARI NO. 28/30
MEDAN SUNGGAL
Bpk HERLINSON /
IBU KIKIMARKETING
061-
4553928,88813615,455731
8,4557218,4553918|
061-4558218 Y Y Y ACTIVE ALL COVERAGE [email protected]
1411 3779 RS. SILOAM DHIRGA SURYAJL. IMAM BONJOL NO. 6, KEL. PETISAH
- MEDAN 20112
EFFENDY/CHARLES
AMIN-
(061) 8888 1900 EXT.
22601|(061) 8888 1933 Y Y Y ACTIVE ALL COVERAGE
effendy.pangestu@siloamhospita
ls.com
1412 4091 RSU. SUNDARI JL. TB SIMATUPANG NO 31 MEDANIBU RINI
KURNIAWATIMARKETING 061-8452536-|- 061-8452536 Y Y Y ACTIVE ALL COVERAGE [email protected]
SUMATERA UTARA
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 52 14/08/2015
No Code Hospital Name Address Contact Person Division Tel Number Fax Number RI RJ FLAG Status Allowed Emails
LIST PROVIDER INDEMNITY UPDATE PER 31 JULI 2015
KHUSUS PT. BANK MANDIRI (PERSERO) Tbk, PT MAYORA Tbk, dan TELADAN PRIMA GROUP
BALI1413 1650 RS. MARTHA FRISKA MULTATULIJL. MULTATULI KOMP. MULTATULI
INDAH NO 1 MEDANIBU DAI MARKETING
061-4149666 /
08286103148|061-4154761 Y Y Y ACTIVE ALL COVERAGE [email protected]
1414 4092 RSIA. SRI RATU JL. NIBUNG RAYA NO 204-212 MEDANIBU EKA
BERNADETAHRD 061-4521074| 061-4539236 Y Y Y ACTIVE ALL COVERAGE [email protected]
1415 4001 RS. MADANI MEDAN
JL. A.R. HAKIM NO. 168, KEL. SUKA
RAMAI I, KEC. MEDAN AREA, KOTA
MEDAN
IRNA PRATIWI MARKETING061-7345911, 061 -
7361357|Y Y Y ACTIVE ALL COVERAGE [email protected]
1416 2028 RS. MITRA SEJATI MEDANJL. AH. NASUTION PANGKALAN
MAHSYUR NO.7, MEDAN
IBU SUSAN
NOVRINI/BAPAK
SUEP
- 061-7875967/ 7881682| 061-7850261 Y Y Y ACTIVE ALL [email protected];
susan.novrini@gmail.
1417 2053 MURNI TEGUH MEMORIAL HOSPITALJL. JAWA NO. 2 SIMPANG JL.
VETERANOMPON marketing 061-80501888/777| 061 - 80501800 Y Y Y ACTIVE ALL COVERAGE
m
1418 2182 KLINIK & APOTEK KF 27 JL. PALANG MERAH NO. 32DRSB. ISMA
PANDIA,APTAPOTEKER 061-4576023| 061-451551 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1419 2297 KLINIK GRAND MADANIJL. SETIA BUDI KOMP. SETIABUDI
POINT BLOK E 12-13, MEDANIBU DEWI APOTEKER 061-8222345| 061-8222929 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1420 2179 APOTEK FARMARIN MEDANJL. GATOT SUBROTO NO. 14 KM 4,2
MEDAN PETISANIBU. RATIH/SRI - 061- 4528454| 061- 4528464 N Y Y ACTIVE ALL COVERAGE [email protected]
1421 2183 KLINIK & APOTEK KF 39 JL. GATOT SOEBROTO NO 37 A/C
RICKY U
MARPAUNG,S.FARM,
APT
APOTEKER 061-4529909| 061-4532717 N Y Y PARTIALGP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1422 2395 SUMATERA EYE CENTER JL. ISKANDAR NO. 278 - 280, MEDANBPK. FAJARUDDIN
NASUTION- 061-4525058 ; 4518222| 061-4510978 Y Y Y ACTIVE ALL COVERAGE
d
PEMATANG SIANTAR
1423 0719 RS. VITA INSANI JL. MERDEKA, NO.329 IBU SUSAN MARKETING 0622-22520| 0622-24521/29133 Y Y Y ACTIVE ALL [email protected];rsvi
@vita-insani.co.id
1424 2208 KIMIA FARMA SOETOMOJL. SUTOMO NO.63 PEMATANG
SIANTARBPK IDRIS - 0622-22447| 0622-25527 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
1425 2984 RS. HARAPAN PEMATANG SIANTAR
JL. FAREL PASARIBU NO : 21
PEMATANG SIANTAR, SUMATERA
UTARA
NESLI M PURB. A Marketing 0622-21162, 21612| 0622-435301 Y Y Y ACTIVE ALL COVERAGE [email protected]
1426 0924 RS. HORAS INSANI JL. MEDAN KM.2,5 PEMATANG SIANTARIBU.CHRISTINA/JUL
TRI/SUZANNAMARKETING
0622-
433444,433877,433666,433
7770622-433777|0622-
433777
0622-21384 Y Y Y ACTIVE ALL [email protected]/rshi
@indo.net.id
1427 2209 KIMIA FARMA KARTINIJL. KARTINI NO. 19 PEMATANG
SIANTARIBU SABRINA APOTEKER 0622-22448| 0622-25527 N Y Y PARTIAL
GP,SP,OP,DENTAL,LAB,RM-RI,RM-
RJ,RM-RG,RM-KM,RM-RB,[email protected]
SIBOLGA
1428 2249 RS. METTA MEDIKAJL. SUTOYO SISWOHARJO NO.34
PASAR BARU, SIBOLGA KOTA
YULIANA
M.SIHOTANG DR.
BENNY, DR
- 0631-25006/25007/25008| 0631-25006 Y Y Y ACTIVE ALL [email protected]
om
LIST PROVIDER INDEMNITY MANDIRI INHEALTH (BANK MANDIRI-MAYORA DAN TELADAN ) - 31 JULI 2015-final revise 53 14/08/2015