Complete form below to signup as a vendor.

General Information

Registered Company Name *

Type of Business *

Address Details

Street Address *

Street Address Line 2

City *

State / Province *

Postal / Zip Code

Country *

Communication Details

Phone Number - Primary *

Area Code

Phone Number

Phone Number - Secondary

Area Code

Phone Number

E-mail *

Website

Registration & Tax

Is the company publicly listed? *

YES

Commercial Registration Number *

Company Tax Number

Company Municipality Number

Paid Up Capital

Company Establishmnet Date *

Business Ownership Details

Business Structure *

Owner / Partner Details *

Name *

Nationality *

Nationality ID / PPT. No *

% of Ownership *

Contact Person Details

Full Name *

Nationality ID *

Designation *

Email Address *

Phone Number - Primary *

Phone Number - Secondary

Required Documents (Uploads in .pdf, .png, .jpg, .jpeg - Max 5MB)

Commercial Registration *

Computer Card

Municipality Registration

MOPH License

Copy of ISO Certificate

VAT Registration

Tax Card

Proof of Authorized signatory*

Company Profile

Partner's Id Copy (If applicable)

Financial Information

Credit Limit *

Credit Days *

Payment Information

Payment Mode *

Bank Information

Name of Bank *

Bank Address *

Account Holder Name *

Swift Code *

IBAN Number *

Currency *

Login Information

Username *

Password *

We hereby confirm that the information provided in this Vendor Registration Form is accurate and Wellcare Pharmacies shall not be liable in any way or form for the information provided. This form is for Vendor Registration purpose only and does not guarantee that work shall be awarded to the Vendor or that Vendor shall be invited to participate in any procurement activities.

Note: Failure to completing this form and attaching it together with the mandatory documents may lead to rejection of application. Wellcare Pharmacies reserves the right to reject any company that does not comply with its requirements.

Instructions

Please provide all necessary information while completing the form.
All mandatory fields are highlighted with an asterisk (*).
It is the sole responsibility of the supplier to ensure all information provided is accurate.
For any supplier registration queries, please contact procurement@wellcarepharmacies.com
Local suppliers must submit electronic copies of the following certificates:
1. Commercial Registration
2. Company Computer Card
These certificates must bear the company stamp, or else the application will be rejected.
International suppliers must submit the required documents according to WCP terms and conditions.

Vendor Registration