Request to Set Up Self-Managed Provider in GS1 US Data Hub | Location

Please complete the form below. Upon receipt, the request for self-management will be processed within one business day.

Preferred Account Name for Self-Managed provider
Location Name for Top Level Node for Self-Managed Provider
GLN for Top Level Node for Self-Managed Provider
Self-Managed Provider Contact Name
Self-Managed Provider Contact Email
GPO requesting set-up
GPO Account Number (found on Data Hub dashboard or in User Profile)
GPO Contact Name
GPO Contact Phone Number (for questions)
GPO Contact Email