Email sent to : MHTContractrequest@molinahealthcare.com  Sub : Enrollment Request - BHUCC - Molina  Good afternoon,  Hope all is well. Here is the enrollment form for Provider and roster of Practice to add provider to an existing contract. Kindly see the attachments.  Practice Details: Practice Name: Best Health Urgent Care & Clinic Practice  NPI # : 1013540962 Practice  TIN # : 84-4737737  Provider : Provider Name: Tann, Shametria Provider  NPI # : 1124615612  If you need any information or documents please let me know . Waiting to hear from you soon.  Thank you! Have a great day!