LIST PROVIDER PT. ASURANSI AXA INDONESIA - ADMEDIKA 8-Nov-17 No Code Hospital Name Address Tel Number Fax Number RI RJ Allowed BALI BADUNG 001 5783 RS. KHUSUS BEDAH BIMC NUSA DUA BALI BLOK D KAWASAN BTDC NUSA DUA 0361-3000911| - Y Y ALL COVERAGE BANGLI 002 4898 RS. BANGLI MEDIKA CANTI JL. TIRTA GIRI KUTRI LCSUBAK AYA BEBALANG, BANGLI, BALI 0366-91555/93444| - Y Y ALL COVERAGE BULELENG 003 1451 RSU. PARAMASIDHI JL. A.YANI NO.171A 0362-29787, 32701,22426,| 0362-29787 Y Y ALL COVERAGE GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 004 3422 LAB. PRODIA SINGARAJA JL. NGURAH RAI NO. 67 SINGARAJA 0362-24516| - N Y RB,PHAR 005 0870 RSU. KERTHA USADA JL. CENDRAWASIH, NO.5-7, SINGARAJA 0362-26277/8| 0362-22741 Y Y ALL COVERAGE DENPASAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 006 2598 KLINIK & APOTEK KF 232 JL. RAYA KEROBOKAN 140, SEMINYAK, KUTA 0361 736163| N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 007 2600 KLINIK & APOTEK KF 236 JL. DANAU BATUR RAYA, TM GRIYA, JIMBARAN 0361 8479785| - N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 008 1825 LAB. PRODIA WIDYA HUSADHA JL. DIPONEGORO NO. 192 DENPASAR (0361) 261001| (0361) 236349 N Y RB,PHAR 009 1245 RSU. SURYA HUSADHA UBUNG JL. COKROAMINOTO, NO.356, DENPASAR 0361-425744| 0361-430557 Y Y ALL COVERAGE GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 010 1202 KLINIK MERDEKA MEDICAL CENTER (MMC) MERDEKA VIII/2 TANJUNG BUNGKAK-DENPASAR 0361-233790| - N Y RB,PHAR 011 1273 RS. SURYA HUSADHA JL. PULAU SERANGAN,NO.7, DENPASAR 0361-233787| 0361-231177 Y Y ALL COVERAGE 012 1309 BALI ROYAL HOSPITAL ( BROS ) JL. TANTULAR NO 6 RENON DENPASAR 0361- 247499/222588/228054| 0361-226051/226052 Y Y ALL COVERAGE 0361-430270 / 430245 / 428287 / 013 1146 RS. BHAKTI RAHAYU DENPASAR JL. GATOT SUBROTO II, NO.11 0361-263371 Y Y ALL COVERAGE 7420673| GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 014 1463 KLINIK PENTA MEDIKA JL. TEUKU UMAR BARAT-MARLBORO,NO.88 0361-7446144/490709| 0361 - 490708 N Y RB,PHAR 015 0220 RS. PRIMA MEDIKA JL. PULAU SERANGAN, 9X 0361 - 236225/257445/235318| 0361-236203/262535 Y Y ALL COVERAGE 016 0179 RSU. KASIH IBU DENPASAR JL. TEUKU UMAR, NO.120 0361-223036/3003030/082146806677| 0361-238690 Y Y ALL COVERAGE 017 0140 RS. MANUABA JL. HOS. COKROAMINOTO, NO.28 0361-426393| 0361-285183/429447 Y Y ALL COVERAGE 018 0221 RS. PURI RAHARJA JL. WR.SUPRATMAN, NO.14-19, DENPASAR 0361-222013| 0361-242537 Y Y ALL COVERAGE GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 019 0867 KLINIK&APOTEK KF 34 DENPASAR JL. DIPONEGORO NO.125, DENPASAR 0361-255914-|- 0361-255914 N Y RB,PHAR 020 1047 RS. BALIMED (d/h RS BALI MEDISTRA) JL. MAHENDRADATTA, NO.57X, DENPASAR 0361-484748, 482281,8450771, 8450772| 0361-8450773,8450770 Y Y ALL COVERAGE 021 1147 RS. DHARMA YADNYA JL. WR.SUPRATMAN NO. 256, TOHPATI 0361-462488 / 462629| 0361-464526 Y Y ALL COVERAGE 022 1150 RSIA. PURI BUNDA JL. GATOT SUBROTO VI, NO.19 0361-437999| 0361-433988 Y Y ALL COVERAGE GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 023 1151 KLINIK QUANTUM SARANA MEDIK JL. RAYA SESETAN, NO.20 0361-228835| 0361-245274 N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 024 3455 APOTIK KIMIA FARMA NO.66 PATIMURA JL. PATIMURA NO.59 DENPASAR 0361-234797| - N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 025 2599 KLINIK & APOTEK KF 82 JL. KARTIKA PLAZA, NO.67, KUTA-BALI 0361 757196| N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 026 4438 KLINIK UTAMA DHARMA SIDHI JL. SERMA KAWI NO. 13-17, DAUH PURI KELOD, DENPASAR BARAT (0361) 242717; 241013| 361241013 N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 027 2602 KLINIK & APOTEK KF 108 JL. T.UMAR 246, DENPASAR 0361 245768| - N Y RB,PHAR GIANYAR 028 1761 RS. ARI CANTI GIANYAR JL. RAYA MAS UBUD GIANYAR 0361-974573| 0361-974573 Y Y ALL COVERAGE 029 4834 RS. KASIH IBU SABA GIANYAR JL. RAYA PANTAI SABA NO 9 DESA SABA, GIANYAR BALI 0361) 3003333| - Y Y ALL COVERAGE 030 3549 RSU. SANJIWANI GIANYAR JL. CIUNG WANARA N0.2 GIANYAR 0361-943049/0361-943020| Y Y ALL COVERAGE JL. HAYANG SANGSI NO.2 PERUM CHANDRA AYU, BANJAR TUBUH, BATU 031 4075 RSU. PREMAGANA 0361-8461955/ 296389 / 082144049401| 0361-295246 Y Y ALL COVERAGE BULAN - SUKAWATI 032 4666 RS. FAMILI HUSADA JL. ASTINA TIMUR, SAMPLANGAN, KEC.GIANYAR, KAB. GIANYAR (0361) 849 3344| (0361) 8493040 Y Y ALL COVERAGE JEMBRANA Jl. Hayam Wuruk No. 23 Ds. Dangintukadaya, Kec. Jembrana, Kab. 033 6026 RS. BALIMED NEGARA 0365-4501452| - Y Y ALL COVERAGE Jembrana 034 3558 RSU. BUNDA JL. RAJAWALI NO. 36, PENDEM, 0365-40251 / 087863229569| 0365-40089 Y Y ALL COVERAGE KARANGASEM GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 035 2301 KLINIK PENTA MEDICA CANDIDASA JL. RAYA MANGGIS NO. 88, KAB. KARANGASEM, BALI 0363-41909| - N Y RB,PHAR 036 4252 RS. BALIMED KARANGASEM JL. NENAS KECICANG BEBANDEM, KARANGASEM, BALI (0363) 4301618| Y Y ALL COVERAGE KUTA 037 1138 RSU. KASIH IBU KEDONGANAN JL. ULUWATU, NO.69A, KEDONGANAN 0361-703270| 0361-703329 Y Y ALL COVERAGE 038 1909 SILOAM HOSPITALS BALI JL. SUNSET ROAD NO. 818, KUTA 0361-779900| 0361-779933 Y Y ALL COVERAGE GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 039 1492 KLINIK KASIH IBU KOMPLEKS PERUM BUMI DALUNG PERMAI, BLOK C1-C4 0361-422150/3700616| 0361-422179 N Y RB,PHAR NUSA DUA GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 040 0222 KLINIK PRIMA MEDIKA JL. BY PASS NGURAH RAI, PERTOKOAN NIAGA, NO.81 0361-770509| 0361-770509 N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 041 2603 KLINIK & APOTEK KF 126 JL. BY PASS NGURAH RAI NO 890,NUSA DUA 0361 778555| - N Y RB,PHAR 042 1359 RSU. SURYA HUSADHA NUSA DUA JL. SILIGITA, BLOK 1, NO.14 0361-775827| 0361-771388 Y Y ALL COVERAGE SANUR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 043 2604 KLINIK & APOTEK KF 173 JL. BY PASS NGURAHRAI 232,SANUR 0361 283395| - N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 044 1248 KLINIK REMEDIUM CARE JL. BY PASS NGURAH RAI NO.243 0361-288860| 0361-287970 N Y RB,PHAR TABANAN GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 045 4520 PRODIA TABANAN JL. NGURAH RAI NO. 43 KEDIRI TABANAN 0361-812758| - N Y RB,PHAR 046 1714 RS. WISMA PRASANTI JL. YAH GANGGA NO. 9 TABANAN , BALI 0361-8043219/810555| 0361-812454 Y Y ALL COVERAGE GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 047 3456 APOTIK & KLINIK KIMIA FARMA.102 TABANAN JL. NGURAH RAI NO.74 A TABANAN 0361-810524| - N Y RB,PHAR 048 2133 RSU. KASIH IBU TABANAN JL. FLAMBOYAN NO. 9 ( KAMPUNG KODOK ) TEGAL BELODAN TABANAN 0361-3005757| 0361-3005758 Y Y ALL COVERAGE UBUD GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 049 0224 UBUD CLINIC JL. TJAMPUHAN, NO.36, P.O.BOX 10, UBUD, GIANYAR 0361-974911| 0361-974910 N Y RB,PHAR BANGKA BELITUNG BANGKA INDUK 050 2148 RS. ARSANI JL. RAYA AIR KENANGA KEC. SUNGAI LIAT KAB. BANGKA BLITUNG 0717-4297825, 4297834| 0717-4297824 Y Y ALL COVERAGE BANGKA TENGAH 051 6122 SILOAM HOSPITALS BANGKA BELITUNG JL. SOEKARNO HATTA KM.5 0710-9190900| - Y Y ALL COVERAGE BELITUNG GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 052 4769 KLINIK BAKTI TIMAH TANJUNG PANDAN JL. MELATI NO. 32 TANJUNG PENDAM 33416 0719-21865| - N Y RB,PHAR 053 2370 RS. ALMAH TANJUNG PANDAN JL. JEND. SUDIRMAN KM. 11 NO. 1 KODE POS 33144 0719-9225666| 0719-9225333 Y Y ALL COVERAGE JL. JENDERAL SUDIRMAN KM. 3 RT.019 RW. 008 KEL. DESA LESUNG 054 4842 RS. UTAMA TANJUNG PANDAN 0719-9222211| 0719-9222212 Y Y ALL COVERAGE BATANG, KEC. TANJUNG PANDAN, KAB. BELITUNG GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 055 1928 KLINIK UTAMA BELITUNG JL. MERDEKA NO. 27 TANJUNGPANDAN BELITUNG 0719-25526| 71925600 N Y RB,PHAR PANGKAL PINANG JL. JEND SUDIRMAN NO. 18, TAMAN BUNGA, GERUNGGANG, KEP BANGKA 056 5045 RSIA. MUHAYA 0717-436997| Y Y ALL COVERAGE BLITUNG GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 057 2605 KLINIK & APOTEK KF 118 JL. A.YANI, P.PINANG 0717 436762| - N Y RB,PHAR GP,SP,OP,DENTAL,LAB,RM-RI,RM-RJ,RM-RG,RM-KM,RM- 058 0900 SUN CLINIC EL-JOHN PLAZA, JL. SUKARNO HATTA, NO.208 0717-4297888-|- 0717-439488 N Y RB,PHAR 059 1508 RS. MEDIKA STANNIA JL. JEND.SUDIRMAN, NO.3, SUNGAI LIAT 0717-95837/93335| 0717-953335 Y Y ALL COVERAGE 060 1443 RS.