Obtain Your HIN

There is a $50 initial fee to obtain your HIN from HIBCC.

The first step is to fill out the Data License Use Agreement.
Next you will be redirected to a page where you will fill out additional information needed to assign the HIN, and you will enter your payment information.
Once all proper paperwork is received, we will initiate a HIN request and once complete, your HIN assignment will be emailed to you.

Data Use License Agreement
By obtaining this data (hereafter called "HINs"), I (hereinafter referred to as the Licensee Organization) hereby agree that I am licensing from the Health Industry Business Communications Council (hereinafter referred to as HIBCC or the Licensor) the use of these HINs for a period of one year for a license fee as calculated as a consequence of this download. I further agree to the following terms:

HINs and any compilation of HINs remain the sole property of HIBCC. Licensee will take no action to infringe on the rights of the Licensor therein.

1. Licensee acknowledges that the Data constitutes valuable copyrighted and proprietary information of Licensor, covered by the Copyright Registrations #TX-8-748-740, #TX-6-589-387, and #TX-5-522-923. Licensee agrees not to sell or release data to any other individual, association, firm, parent or subsidiary organization, or other entity whatsoever, except as permitted by Licensor. The HIBCC Authorized Licensees list can be found at: here

2. If the Licensee is a data reselling organization Licensee agrees to use the HINs strictly for internal uses, and is prohibited from selling or otherwise distributing or disclosing HINs to any third party, including customers or clients of Licensee, without prior written consent of Licensor.

3. This Agreement shall take effect upon completion of the download of HIN data.

4. The obligation of confidence and nondisclosures assumed by Licensee hereunder shall not apply to: a) Information which at the time of disclosure is in the public domain; or b) Information which thereafter lawfully becomes a part of the public domain other than through disclosure by Licensee; or c) Information known to Licensee prior to licensors’ disclosures to Licensee; or d) Information which is lawfully disclosed to Licensee by a third party not under an obligation of confidentiality to licensor with respect to said information.

5. This agreement and HIN are renewable annually upon payment of a $25 annual renewal fee (licensure will be notified by HIBCC annually).

Having read the above, and having understood the terms and conditions of the Agreement, Licensee agrees to assume full responsibility for compliance with this Agreement. Any breach of this Agreement or any term there in will subject Licensee to any and all injunctive relief and legal and equitable remedies available to the Licensor.
Name of Licensee Organization*
Contact Name*
First Last
Title*
Contact Email Address*
Contact Phone Number
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Data Use License Agreement*
I agree to the Data Use License Agreement.
Date*
Date Format: DD slash MM slash YYYY
Obtain Your HIN
To obtain your HIN, please fill out the information below. HINS will be emailed to you within 3 business days of your submission. Should you have any questions, please email dba@hibcc.org.
HIN FEE*
Price: $50.00
HIN will be assigned to this location.
Organization/Company*
Shipping Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone*
Are you applying for a 340B HIN? (340B ID must be provided.)*
- Yes
- No
Enter 340B ID
Type of Business*
Billing Contact Information
Organization/Company*
Name*
First Last
Title*
Billing Address*
This is the address that will be use for your credit card. Please ensure it matches for transaction to complete.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Billing Telephone*
Billing Email*
Credit Card Details*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00
*
By checking this box, I authorize HIBCC to charge my credit card above for the agreed upon transaction. The HIN fee is non-refundable and will be processed according to the information submitted on this form.
Do not click the "Submit" button more than once. Doing so could result in duplicate charges to your credit card.
Phone
This field is for validation purposes and should be left unchanged.

Obtain Your HIN

Data Use License Agreement

Obtain Your HIN

Billing Contact Information