PT.

Global Asistensi Manajemen Indonesia (GAMI)

Our Provider Network Listing

Welcome to our Provider Network! Note that we have many Networks to suit different Clients so make certain you are using the right List.
Check with your Insurance Company, HRD or with our Customer Service staff if you are not sure.

This is our Network List for Indonesia Only, All Services, All Classes.

If you are not certain what services you are entitled to use on a cashless basis, please check your insurance policy or talk to your Human
Resources Department (HRD). If you would like details of our other network providers, an "All Providers" list is available from our website at
www.Global-Assistance.net.

The cashless medical services available from each of the Facilities listed are indicated with a P mark (see below). Note also that the
cashless services available to you personally will depend on your insurance policy or company entitlements.

If you have any questions regarding this list, or if you experience any problems of any kind in accessing services from these Providers, please
call the customer service number on the back of your Membership Card or call us on (021) 782 8022.

We continue to build and expand our Network of Providers to suit our clients - so please check for updates to this list at our website
www.Global-Assistance.net.

Abbreviations used below are as follows...

IP = Inpatient services MA = Maternity Services OP = Outpatient services DB = Basic Dental services
DC = Complex Dental services Opt = Optical services MC = Medical Checkup services

INDONESIA

State/Province: Bali

Denpasar
Facility Name Type Address Telephone IP M O DB DC Opt M

Jimbaran Clinic Clinic - 24 Hours JL. By Pass Ngurah Rai No. 95 XX, (0361) 701467 P
Kedonganan - Tuban
Kimia Farma Clinic Clinic - 24 Hours Jl.Diponegoro No.125, Denpasar (0361) 255 914 P
Klinik Penta Medica Clinic - 24 Hours Jl. Teuku Umar Barat, Marlboro No. 88 (0361) 7446144 P
Kuta Clinic Clinic - 24 Hours Jl. Raya Kuta 100X, Kuta (0361) 758 495 P
Merdeka Medical Centre (MMC) Clinic - 24 Hours Jl. Merdeka VIII / 2 Tanjung Bungkak, (0361) 233 790 P P P
Denpasar
Nusa Dua Clinic Clinic - 24 Hours Jl.Pratama No.81A-81B, Nusa Dua (0361) 778 098 P P
Poliklinik&Apotek Metta Beliton Clinic - Not 24 Hours Jl. Beliton No. 1 (0361) 227334 P
RB Kasih Ibu Dalung Permai Hospital & Clinic Kompleks Perumahan Bumi Dalung (0361) 3093939 P P P
Permai Blok C1 - C4
Remedium Care Clinic Clinic - 24 Hours Jl. By Pass Ngurah Rai No. 243, Sanur (0361) 7430729 P P
RS BaliMed Hospital & Clinic Jl. Mahendratta No. 57, Denpasar (0361) 8450773 P P P P P
RS Kasih Ibu Bali Hospital & Clinic Jl. Teuku Umar 120, Denpasar (0361) 223 036 P P P P P
RS Prima Medika Hospital & Clinic Jl. P. Serangan No.9 X (0361) 236 225 P P P
RSB Aricanti Maternity Only Hospital Jl. Raya Mas, Ubud (0361) 974 573 P P P
RSIA Puri Bunda Denpasar Hospital & Clinic Jl. Gatot Subroto VI/19, Denpasar (0361) 437 999 P P P
RSU Kasih Ibu Kedongan Hospital & Clinic Jl. Uluwatu No. 69 A, Kedongan - Kuta (0361) 703270 P P P P P
RSU Sari Dharma Hospital & Clinic Jl. Pulau Seram 8, Denpasar (0361) 226 866 P P P P P

Released: 12 May 2010, 1:53:55PM Page 1 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Bali

Singaraja
RSU Grehosadha Parama Sidhi Hospital & Clinic Jl. Ahmad Yani No. 117 A, (0362) 32701 P P P P P
Baktiseraga - Singaraja

State/Province: Banten

Cilegon
Klinik Al Falah Hospital & Clinic Ruko Sukmajaya Blok B No. 20 (0254) 7035602 P P
Klinik Amalia Cilegon Clinic - 24 Hours Jl. SA. Tirtayasa No. 7 (0254) 391307 P P
Klinik Bona Medika Clinic - 24 Hours Festival Ruko Blok B. 10-11, (0254) 387684 P P
Bonakarta
Klinik Prima Husada Cilegon Clinic - 24 Hours Jl. Raya Merak No. 36 (0254) 391688 P P
Klinik Pusat Kesehatan Ananda Clinic - 24 Hours Jl. R. Suprapto KM 8 (0254) 310609 P P
Klinik Serang Medika Clinic - Not 24 Hours Jl. Raya Serang Cilegon Ruko Legok (0254) 223992 P P
Sukma Jaya
Klinik Utama Medical Service II Clinic - Not 24 Hours Jl. Letjend Suprapto No. 9 Rawanuju (0254) 220422 P P
Klinik&Apotik Waringin Clinic - Not 24 Hours Jl. Raya Waringin Kurung Serdang (0254) 310609 P P
Klinik-Apotik Prima Sehat Clinic - Not 24 Hours Jl. SA. Tirtayasa No. 96 (0254) 391688 P
RS Krakatau Medika Hospital & Clinic Jl. Semang Raya, Cilegon (0254) 396 333 P P P P
RSIA Kurnia Cilegon Hospital & Clinic Jl. Jombang Mesjid No. 4 (0254) 391161 P P P P P
RSIA Mutiara Bunda Cilegon Hospital & Clinic Jl. SA Tirtayasa No. 86 (0254) 376888 P P

Pangdeglang
Klinik Difa 24 Jam Clinic - 24 Hours Jl. Raya Labuan KM.12, Menes (0253) 502160 P P

Rangkas Bitung
RS Misi Lebak Hospital & Clinic Jl. Multatuli No. 41 Rangkasbitung (0252) 201014 P P P P P

Serang
Klinik & Apotik Ratu Farma Clinic - Not 24 Hours Jl. Maulana Yusuf No. 17 (0254) 200465 P
Klinik Cijawa Medika Clinic - Not 24 Hours Jl. KH. A. Fatah Hasan No. 8 (0254) 204735 P P
Klinik Ikhlas Medika I Clinic - 24 Hours Kompleks Bumi Agung Permai (0254) 207918 P P
Klinik Ikhlas Medika II Clinic - 24 Hours Jalan Raya Serang Jakarta- (0254) 207918 P P
Pakupatan
Klinik Modern Medika Cikande Clinic - Not 24 Hours Jl. Raya Serang KM. 68, Ruko Modern (0254) 400554 P
Medika, Cikande
Klinik Modern Medika Kragilan Clinic - 24 Hours Jl. Raya Serang KM. 15 Ruko D-9, (0254) 281720 P
Kragilan - Serang
Klinik Utama Medical Service I Clinic - Not 24 Hours Jl. Kol. H. Tb. Suwandi Ruko Puri Tiara (0254) 220422 P P
No. 17
Klinik Wahana Sehat Clinic - Not 24 Hours Jl. Juhdi No. 31 (0254) 207374 P P
Klinik Wisata Medika Clinic - Not 24 Hours Jl. Raya Anyer No. 09 (0254) 605141 P P
RS Kencana Serang Hospital & Clinic Jl. A. Yani No. 21 (0254) 211554 P P P P P
RSIA Budi Asih Serang Hospital & Clinic Jl. K.H Sokhari No. 39 (0254) 212484 P P P P

Released: 12 May 2010, 1:53:56PM Page 2 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Banten

Tangerang
Apotek Century Plaza Bintaro Pharmacy Plaza Bintaro Jaya LT. 1 Blok D3, Jl. (021) 7353485
Bintaro Utama IIIA Pondok Aren
Clinic Pamulang Medical Centre Clinic - 24 Hours Jl.Pamulang Raya, Blok DII/2 - (021) 740 5317 P P
Pamulang
Klinik & RB Pinang Sari I Clinic - 24 Hours Jl. KH. Hasyim Ashari no.9, Cipondoh (021) 731 2915 P P P
Klinik Anakku BSD Clinic - Not 24 Hours Ruko Golden Madrid 2 Blok I - 8, Jl. (021) 7091 3227 P P P
Letjen Sutopo BSD City
Klinik Banjar Medika Clinic - 24 Hours JL. KH. Hasyim Ashari 001/004 NO.28, (021) 5541401 P P
Cipondoh
Klinik Bunda Medika Clinic - 24 Hours Jl. Aria Putra No. 114, Kedaung (021) 740 2465 P P
Pamulang
Klinik dan Apotik Mulya Clinic - 24 Hours Jl. KH. Hasyim Ashari No. 10 Sudimara (021) 730 7888 P
Pinang, Pinang
Klinik Dr. Nenie Herawati Clinic - Not 24 Hours Villa Melati Mas, Jl. Melati Raya C (021) 7023 0383 P
II/No. 3
Klinik Karuna Medika Clinic - 24 Hours Jl. Imam Bonjol Kav. 19-20, Kavling (021) 5588776 P P
Pemda Karawaci
Klinik Medifarma Pondok Cabe Clinic - Not 24 Hours Ruko Pondok Cabe Mutiara Blok C II - (021) 742 7803 P P
12A, Jl Pondok Cabe Raya, Pamulang
Klinik Pinang Sari II Clinic - 24 Hours Jl. KH. Mas Mansyur no.90, Cipondoh (021)7344 0767 P
Klinik Provita Clinic - 24 Hours Jl. Ir. H. Juanda No. 125, Ciputat (021) 7492619 P P
Klinik Sapta Mitra Tangerang Clinic - 24 Hours Jl. Pandaan Raya No. 21 Perumnas I, 021-55799768 P P
Cibodasari - cibodas
Klinik Selaras Clinic - 24 Hours Jl. Raya Serpong RE No. 43 - 45 BSD (021) 537 0310 P
Sektor IV
Klinik Siliwangi Medika Clinic - 24 Hours Jl. Siliwangi D2/ 11, Ciputat (021) 740 5330 P P
Klinik Sumber Sehat Medika Clinic - Not 24 Hours Jl. Raya Pasar Baru No. 5 (021) 552 0731 P P
Mayapada Hospital Hospital & Clinic Jl.Honoris Raya Kav 6, Kota Modern (021) 552 9035 P P P P P P
Omni Internasional Hospital Hospital & Clinic Jl. Alam Sutera Boulevard Kav. 25, (021) 53125555 P P P P P P
Serpong
RS Aminah Hospital & Clinic Jl. HOS Cokroaminoto (Ciledug Raya) (021) 737 1919 P P P P P
No. 4A, Kreo Selatan - Larangan
RS An-Nisa Tangerang Hospital & Clinic Jl. Gatot Subroto No. 96 KM. 3, (021) 5525564 P P P P P
Cibodas
RS Ariya Medika Hospital & Clinic Jl. Industri Raya I Blok A No. 1 - 10, 021-5902229 P P P P P
Jatake
RS Asshobirin Hospital & Clinic Jl. Raya Serpong KM. 11, Pondok (021) 5374293 P P P P P
Jagung
RS Global Medika Hospital & Clinic Jl. MH Thamrin No. 3 Cikokol (021) 55780888 P P P P P P
RS Ichsan Medical Centre (IMC) Hospital & Clinic Jl. Raya Jombang No. 56, Bintaro (021) 7456379 P P P P P
Bintaro Sektor IX
RS Internasional Bintaro Hospital & Clinic Jl. MH Thamrin Blok B3 No.1, Sektor 7, (021) 745 5500 P P P P P P
Bintaro Jaya
RS Melati Hospital & Clinic Jl. Merdeka No. 92 (021) 552 3945 P P P
RS Paramita Hospital & Clinic Kawasan Industri CCM Kav. FL -8, Jl. (021) 5954858 P P P P P
Raya Serang KM. 28.5, Balaraja
RS QADR Hospital & Clinic Komp. Islamic Village, Desa Kelapa (021) 546 4466 P P P
Dua PO Box 492
RS Sari Asih Karawaci Hospital & Clinic Jl. Imam Bonjol no 38, Karawaci (021) 552 2794 P P P P P
RS Syarif Hidayatullah Hospital & Clinic Jl.Ir.H Juanda No.95, Ciputat (021) 740 2718 P P P P P
RS Usada Insani Hospital & Clinic Jl. KH. Hasyim Ashari 24, Tangerang (021) 5575 2575 P P P P
RS. Sari Asih Ciledug Hospital & Clinic Jl. HOS. cokroaminoto No. 38, Ciledug (021) 7333430 P P P P P
RSB Permata Sarana Husada Maternity Only Hospital Pamulang Permai Blok D3 No. 2, (021) 7407422 P P P
Pamulang - Tangerang
RSIA Bunda Sejati Maternity & Children Jl. Prabu Siliwangi No. 11 Jatiuwung (021) 5900136 P P P P P
RSIA Cinta Kasih Hospital & Clinic Jl. Ciputat Baru Raya No. 10, Ciputat (021) 7424639 P P P P P
RSIA Lestari Cirendeu Tanggerang Hospital & Clinic Jl. Cirendeu Indah III No. 37, Ciputat (021) 740 9969 P P P P P
RSIA Putra Dalima Hospital & Clinic Jl.Rawabuntu Utara Sektor 1-2 Blk (021) 537 6002 P P P
UA26-27, BSD - Tangerang
RSIA Sari Asih Sangiang Hospital & Clinic Jl. Moh. Toha (Jl. Raya Mauk) KM. 3.5 (021) 5582732 P P P
RSIA Selaras Maternity & Children Jl. Raya Serang Km.18,5 Desa Bojong (021) 596 9145 P P P
Cikupa
RSU Bhakti Asih Hospital & Clinic Jl. Rd. Saleh No. 10, Karang Tengah (021) 730 5663 P P P
Raya
RSU Mulya Hospital & Clinic Jl. KH. Hasyim Ashari No. 18, (021) 732 2443 P P P P P
Sudimara, Pinang
Siloam Hospitals Lippo Village Hospital & Clinic Jl. Siloam No.6, Lippo Karawaci 1600 (021) 546 0055 P P P P P P

Released: 12 May 2010, 1:53:56PM Page 3 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Bengkulu

RS Rafflesia Bengkulu Hospital & Clinic Jl. Mahoni No. 10 (0736) 21710 P P P P P

State/Province: Jakarta

Jakarta Barat
Apotek Century Carrefour Daan Pharmacy Carrefour Daan Mogot KM. 21, Lt. (021) 5532226
Mogot Ground Blok C No. 1
Apotek Century Mall Ciputra Pharmacy Mall Ciputra LT Upper Ground No. 95 (021) 5663612
A, Grogol
Apotek Century Mall Daan Mogot Pharmacy Daan Mogot Mall Lt. Dasar No. 2&3 (021) 5456134
Apotek Century Puri Farma Pharmacy Pasar Puri Indah, Jl. Puri Indah Raya 1 (021) 5824860
No. 7 Kembangan Selatan
Jakarta Eye Center Kebon Jeruk Hospital & Clinic Gedung Graha Multi, Jl. Panjang No. (021) 5306 754 P P
55 Kebon Jeruk
Klinik Anggrek - Tenis Raya Clinic - Not 24 Hours Jl.Tenis Raya No. 8 C (021) 99711627 P P
Klinik Kusuma Clinic - Not 24 Hours Jl. Peta Selatan No. 50 (021) 5419747 P P
Klinik Yadika Tegal Alur Clinic - 24 Hours Jl. Kamal Raya A7 No. 7-11, Tegal Alur (021) 70605247 P P
RS Hermina Daan Mogot Hospital & Clinic Jl. Kintamani Raya No.2 Kawasan (021) 540 8989 P P P P P
Daan Mogot
RS Jantung Harapan Kita Hospital & Clinic JL. Letjen. S Parman Kav. 87 Slipi (021) 5681111 P P
RS Kanker Dharmais Hospital & Clinic Jl. S. Parman Kav 84-86, Slipi (021) 568 1570 P P
RS Medika Permata Hijau Hospital & Clinic Jl.Raya Kebayoran Lama, No. 64 (021) 534 7411 P P P P P
RS MH. Thamrin Cengkareng Hospital & Clinic Jl. Daan Mogot Km. 17, Cengkareng (021) 619 4581 P P P P
RS Pelni Petamburan Hospital & Clinic JL AIP II KS Tubun 92-94 (021) 548 0608 P P P P P
RS Puri Indah Hospital & Clinic Jl. Puri Indah Raya Blok S-2, (021) 2569 5322 P P P P
Kembangan Selatan
RS Royal Taruma Hospital & Clinic Jl. Daan Mogot No. 34, Grogol (021) 56967788 P P P P P P
RSAB Harapan Kita Maternity & Children Jl. Letjen S Parman Kav.87, Slipi (021) 566 8284 P P P
RSUD Cengkareng Hospital & Clinic Jl. Kamal Raya, Bumi Cengkareng (021) 5437 2874 P P P P P
Indah, Cengkareng Timur
Siloam Hospitals Kebon Jeruk Hospital & Clinic Jl Raya Pejuangan, Kebon Jeruk (021) 530 0888 P P P P P P

Released: 12 May 2010, 1:53:56PM Page 4 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jakarta

Jakarta Pusat
Jakarta Eye Centre - Menteng Hospital & Clinic Jl. Cik Ditiro NO. 46, Menteng (021) 3107 434 P P
Klinik Al - Afiat Clinic - 24 Hours Jl. K. H. Mas Mansyur No. 74 C, Tanah (021) 392 5206 P
- Abang
Klinik Baruna Clinic - 24 Hours Jl. Cikini Raya No.60 (021) 314 1040 P P
Klinik Citra Petamburan Clinic - 24 Hours Jl. AIP II KS Tubun No. 39 (021) 568 8846 P
Klinik Drg. Efindy Clinic - Not 24 Hours Jl. Kebon Kacang I No. 98 (021) 30040151 P
Klinik Medisari Clinic - 24 Hours Jl. Rawasari Barat No. E281, Rawasari (021) 422 4383 P
Klinik Rawasari Clinic - 24 Hours Jl. Percetakan Negara no. D - 764 (021) 421 2528 P
Klinik Sarana Medika Clinic - Not 24 Hours Jl. Taman Kimia No.1 (021) 31922 357 P
Raden Saleh Medical Centre Clinic - 24 Hours Jl. Raden Saleh Raya No. 4, Gedung (021) 31923508 P P P
Dinar Lt. 1
RS (YPR) Yayasan Panti Raharja Hospital & Clinic Jl. Sawo No. 58 - 60 (021) 3192 2553 P P P P P
"SAWO"
RS Abdi Waluyo Hospital & Clinic JL. HOS. Cokrominoto 33, Menteng (021) 314 4989 P P P P P
RS Bersalin YPK Hospital & Clinic Jl. Gereja Theresia 22 (021) 3909725 P P P
RS Bunda Jakarta Hospital & Clinic Jl. Teuku Cik Ditiro No.28, Menteng (021) 3192 2005 P P P P
RS Husada Hospital & Clinic Jl. Mangga Besar, No.137-139 (021) 649 0090 P P P
RS Islam Jakarta Cempaka Putih Hospital & Clinic Jl Cempaka Putih, Tengah I/1 (021) 425 0451 P P P P P
RS Khusus THT Bedah Hospital & Clinic Jl. Proklamasi 43 (021) 390 0002 P P
"Proklamasi"
RS Kramat 128 Hospital & Clinic Jl. Kramat Raya No.128 (021) 390 9514 P P P
RS Menteng Mitra Afia Hospital & Clinic Jl. Kali Pasir No.9, Cikini (021) 315 4050 P P P
RS MH. Thamrin Internasional Hospital & Clinic Jl.Salemba Tengah 26-28 (021) 390 4422 P P P P P P
Salemba
RS Pertamina Jaya Hospital & Clinic Jl. Jend. A.Yani No.2, By Pass (021) 421 1911 P P P P
RS PGI Cikini Hospital & Clinic Jl. Raden Saleh No. 40 (021) 38997777 P P P P P
RS St. Carolus Hospital & Clinic Jl Salemba Raya 41 (021) 390 4441 P P P P P P
RSIA Evasari Maternity & Children Jl. Rawamangun No.45-47 (021) 420 2851 P P P P P
RSIA Tambak Maternity & Children Jl. Tambak No. 18, Manggarai (021) 2303444 P P P
RSPAD Gatot Soebroto "Pav. Hospital & Clinic Jl. Dr. Abd. Rachman Saleh No.24 (021) 350 0004 P P P P P
Dharmawan"
RSPAD Gatot Soebroto "Pav. Hospital & Clinic Jl. Dr. Abd. Rachman Saleh No.24 (021) 384 0484 P P P P P
Kartika"
RSPAD Gatot Soebroto (Pav Ika) Hospital & Clinic Jl. Dr. Abdul Rahman Saleh No. 24 (021) 3441008 P P P P
RSPAD Gatot Soebroto Pav Dr Hospital & Clinic Jl. Dr. Abd. Rachman Saleh No.24 021-3504941-2 P P P P P
Imam Sudjudi
Sahid Sahirman Medical Centre Clinic - Not 24 Hours Ground Fl. Istana Sahid Apartment, (021) 572 7208 P
Jl.Jend.Sudirman 86
SBU Garuda Sentra Medika Clinic - 24 Hours Jl. Kebon Sirih No. 44 (021) 424 1000 P P
Sentra Medika Internasional (SMI) Clinic - 24 Hours Jl. HOS Cokroaminoto No. 16 (021) 3144989 P
Wellness Clinic Clinic - 24 Hours Jl. Pegangsaan Timur No. 21, Megaria (021) 390 9672 P
Complex

Released: 12 May 2010, 1:53:56PM Page 5 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jakarta

Jakarta Selatan
Apotek Century Duta Indah Pharmacy Ruko Plaza Pondok Indah I Blok UA (021) 7692006
No. 34
Clinic Aditya Medical Center Clinic - 24 Hours Jl. Adityawarman I/14, Kebayoran Baru (021) 720 3180 P
Clinic ESTI Clinic - 24 Hours Jl. Bangka Raya No.28-30 (021) 719 4434 P P
deBlitz'R Dental Care Dental Clinic Bellezza Shopping Arcade Unit (021) 5366 4742 P P
230-231, Jln. Letjend Supeno No. 34
Fira Aruan Medical Care Clinic - Not 24 Hours Gedung BEJ - Tower 1 LL Floor, Jl. (021) 70556161 P P
Sudirman Kav. 52-53
Hendra Hidayat Implant Center Clinic - Not 24 Hours Sahid Sudirman Residence FI, 1 Unit (021) 5250180 P
1, Jl. Jend.Sudirman 86
Jakarta Medical Center Clinic Clinic - 24 Hours Jl. Buncit Raya No. 15 (021) 794 0836 P P
Klinik & Apotik Namira Clinic - Not 24 Hours Jl. Jatipadang Raya No. 62, Pasar (021) 7820645 P P
Minggu
Klinik All Care Dental Clinic Dental Clinic Plaza 5 Blok B/15 Jl. Margaguna Raya, (021) 7278 8688 P P
Pondok Indah
Klinik Citra Kebayoran Clinic - 24 Hours Jl. Raya Kebayoran Lama No. 33 (021) 536 73906 P
Klinik Dharma Bhakti Clinic - Not 24 Hours Jl. Cilandak KKO Raya No. 45 (021) 781 9848 P
Klinik Medika I Clinic - 24 Hours Jl. Radio Dalam Raya No. 8 (021) 725 0849 P P
Klinik Medika II Clinic - 24 Hours Jl. Buncit Raya No. 38 (021) 798 5178 P
Klinik Medika Pura Clinic - Not 24 Hours Jl. Tebet Raya No. 31 (021) 83792701 P P
Klinik Medira Jakarta Clinic - 24 Hours Jl. Taman Margasatwa No. 24 (021) 780 1830 P
Klinik Medusa Sentra Medika Clinic - Not 24 Hours Wisma Mulia Lt. 23, Jl.Jend Gatot (021) 52906465 P P
Subroto Kav. 42
Klinik Petukangan Medical Centre Clinic - Not 24 Hours Jl. Ciledug Raya No. 8A, Petukangan (021) 7340906 P P
Klinik Tiara Clinic - 24 Hours Jl. Senopati No.84 (021) 7210 980 P
Klinik Yadika Petukangan Clinic - 24 Hours Jl. Damai Raya No.1 Petukangan (021) 737 0881 P P
Selatan
Medicare Clinic Clinic - Not 24 Hours Menara Kadin Ind.27th Fl. Jl.HR (021) 527 4556 P P P P
Rasuna Said X/5, Kav.2-3
Medikaloka Health Care Center Clinic - Not 24 Hours Graha Irama 2nd floor, HR Rasuna (021) 5261118 P P
said blok x-1
Nusantara Medical Center Clinic - Not 24 Hours Gd. Granadi 3rd Fl. J. Rasuna said, (021) 527 4567 P P P P
Kav. 8-9 Kuningan
RS Agung Manggarai Hospital & Clinic Jl. Sultan Agung No.67, Manggarai (021) 829 4955 P P P P
RS Asri Duren Tiga Hospital & Clinic Jl. Duren Tiga Raya No. 20 (021) 7992211 P P P P P
RS Dr. Suyoto Hospital & Clinic Jl. RC. Veteran No.178 Bintaro (021) 734 2012 P P P P P
RS Gandaria Hospital & Clinic Jl. Gandaria Tengah II/6, Kebayoran (021) 725 0718 P P P
Baru
RS Jakarta Hospital & Clinic Jl. Jend Sudirman Kav.49 (021) 573 2241 P P P P P P
RS Jakarta Medical Center Hospital & Clinic Jl. Buncit Raya No. 15 (021) 798 0888 P P P P
RS Khusus THT & Bedah Ciranjang Hospital & Clinic Jl. Ciranjang No.20&22, Kebayoran (021) 7243 366 P P
Baru
RS Medistra Hospital & Clinic Jl. Gatot Subroto Kav. 59 (021) 521 0200 P P P P P P
RS Pondok Indah Hospital & Clinic Jl. Metro Duta Kav.UE, Pondok Indah (021) 765 7525 P P P P P P
RS Prikasih Hospital & Clinic Jl. RS Fatmawati No. 74, Pondok Labu (021) 750 4669 P P P P
RS Pusat Pertamina Hospital & Clinic Jl. Kyai Maja No.43, Kebayoran Baru (021) 7219400 P P P P P P
RS Setia Mitra Hospital & Clinic Jl. RS Fatmawati, No.80-82 (021) 765 6000 P P P P P
RS Siaga Raya Hospital & Clinic Jl. Siaga Raya Kav. 4-8, Pejaten Barat (021) 797 2750 P P P P
Ps. Minggu
RS Tebet Hospital & Clinic Jl. Letjen MT. Haryono No. 8 (021) 830 7540 P P P P P
RS Tria Dipa Hospital & Clinic Jl Raya Pasar Minggu No.3A, (021) 797 4071 P P P P P
Pancoran
RS Zahirah Hospital & Clinic Jl. Sirsak No. 21, Jagakarsa (021) 78888723 P P P P P
RSB Duren Tiga Hospital & Clinic Jl. Duren Tiga Raya N0. 5, Pancoran (021) 7976605 P P
RSB Panti Nugraha Maternity Only Hospital Jl. Senayan No.26, Kebayoran Baru (021) 722 3939 P P P
RSIA Aulia Maternity Only Hospital Jl. Jeruk Raya No.15, Jagakarsa (021) 727 0208 P P P P P
RSIA Budhi Jaya Maternity Only Hospital Jl. DR Saharjo No 120 (021) 8311722 P P P P P
RSIA Kemang Medical Care Maternity & Children Jl. Ampera Raya No.34, Ragunan (021) 27545454 P P P P P
RSIA Muhammadiyah Taman Hospital & Clinic Jl. Gandaria I/20, Kebayoran Baru - (021) 7208358 P P P P P
Puring Jaksel
RSIA Yadika Kebayoran Lama Maternity & Children Jl. Ciputat Raya No.5 Kebayoran Lama (021) 729 1074 P P P P P
Sahid Sahirman Memorial Hospital Hospital & Clinic Jl. Jend. Sudirman No. 86 (021) 57853911 P P P P P
Suryatenggara Dental Clinic Clinic - Not 24 Hours Jln. Karet Pedurenan 240, RT 005/06 (021) 5225595 P
Kec. Setiabudi
Brawijaya Women&Children Hospital & Clinic Jl. Taman Brawijaya No. 1, Cipete (021) 7211337 P P P P P
Hospital Utara

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jakarta

Jakarta Timur
Klinik Batu Ampar Clinic - Not 24 Hours Jl. Batu Ampar III No. 5, Kramat Jati (021) 8088 6446 P
Klinik Bina Husada Bhakti Clinic - 24 Hours Jl. Penggilingan Raya No. 1 RT.01/07 (021) 46829425 P P
Klinik Devita Clinic - Not 24 Hours Jl.Jatinegara Timur No. 5, Jatinegara (021) 8191312 P P P
Klinik Drg. Hari Sumitro Dental Clinic Jl. Raya Jatinegara 57 A, (Klinik (021) 851 6274 P P
Devita)
Klinik Era Medika Clinic - Not 24 Hours Jl. Dewi Sartika No. 292c, Cawang (021) 808 70172 P P
Klinik Medika Group Clinic - 24 Hours Jl. Batu Ampar III No. 5, Kramat Jati (021) 808 86446 P P
Klinik Medista Jakarta Clinic - 24 Hours Jl. Otista Raya No. 82 (021) 819 8693 P
Klinik Mitra Cakung Clinic - 24 Hours Jl. Balai Rakyat No.17, Cakung Timur (021) 921 3801 P
Klinik Mitra Kramat Jati Clinic - 24 Hours Jl. Masyid Al - Amin No.10 (021) 922 8909 P
Klinik Sapta Mitra Duren Sawit Clinic - 24 Hours Jl. Pondok Kelapa Raya Ruko Blok C4 (021) 8651331 P P
No. 2E, Duren Sawit
Klinik Sartika Clinic - Not 24 Hours Jl. Dewi Sartika No. 22 (021) 910 0682 P
Klinik Suci Husada Clinic - Not 24 Hours Jl. Suci No. 21 Susukan, Ciracas (021) 87798796 P P
Klinik Tjakra Cijantung Clinic - Not 24 Hours Jl. Raya Bogor KM. 24 No. 12 A, (021) 8401677 P P P
Cijantung
Klinik Waras Medika Clinic - Not 24 Hours Jl. H. Ten No.41 (021) 489 1244 P
RS Dharma Nugraha Hospital & Clinic Jl. Balai Pustaka Baru, No. 19, (021) 470 7433 P P P P P
Rawamangun
RS Fakultas Kedokteran UKI Hospital & Clinic Jl. Sutoyo - Cawang (021) 809 2317 P P P
RS Haji Jakarta Hospital & Clinic Jl.Raya Pondok Gede (021) 800 0693 P P P P P
RS Harapan Bunda Jakarta Hospital & Clinic Jl. Raya Bogor Km. 22 (021) 840 0257 P P P P P
RS Harum Hospital & Clinic Jl.Tarum Barat, Kali Malang (021) 861 7212 P P P P P
RS Islam Jakarta Timur Hospital & Clinic JL. Raya Pondok Kopi (021) 863 0654 P P P P P
RS Khusus Jantung Binawaluya Hospital & Clinic Jl. TB. Simatupang No. 71 (021) 8778 1605 P P
RS Mediros Hospital & Clinic Jl. Perintis Kemerdekaan, Kav. 149 (021) 472 1336 P P P
RS MH. Thamrin Pondok Gede Hospital & Clinic Jl. Raya Pondok Gede, No. 23-25 (021) 809 3602 P P
RS Mitra Internasional Hospital & Clinic Jl. Raya Jatinegara Timur, No.85-87 (021) 280 0888 P P P P P
RS Omni Medical Center Hospital & Clinic Jl. Pulomas Barat VI. (021) 472 3332 P P P P P P
RS Rawamangun Hospital & Clinic Jl. Balai Pustaka Raya No.29-31, (021) 4893531 P P P P P
Rawamangun
RS Yadika Pondok Bambu Hospital & Clinic Jl. Pahlawan Revolusi No.47, Pondok (021) 861 5754 P P P P P
Bambu
RS. Kepolisian Pusat Raden Said Hospital & Clinic Jl. Raya Bogor, Kramat Jati (021) 8093288 P P P P P
Sukanto
RSIA Bunda Aliyah Maternity & Children Jl. Pahlawan Revolusi No. 100, (021) 8660 2525 P P P P
Pondok Bambu
RSIA Hermina Jatinegara Maternity & Children Jl. Raya Jatinegara Barat, No. 126 (021) 8191 223 P P P P P
RSIA Resti Mulya Hospital & Clinic Jl. Komarudin Raya No. 5, (021) 4802192 P P P P P
Penggilingan

Jakarta Utara
Oilia Medical Centre Clinic - Not 24 Hours Jl. Swasembada Barat 12/2E (021) 43901357 P P
RS Atmajaya Hospital & Clinic Jl. Pluit Raya No. 2 (021) 660 6127 P P
RS Islam Jakarta Utara Hospital & Clinic Jl.Tipar, Cakung No. 5, Sukapura (021) 440 0778 P P P P P
RS Mitra Keluarga Kelapa Gading Hospital & Clinic Jl. Bukit Gading Raya, Kav. 2 Kelapa (021)4585 2700 P P P P P P
Gading
RS Mitra Kemayoran Hospital & Clinic Jl. Landasan Pacu Timur, Kemayoran (021) 654 5555 P P P P P P
RS Port Medical Center Hospital & Clinic Jl. Enggano No. 10, Tanjung Priok 021-43902350 P P P P P
RS Puri Medika Jakarta Hospital & Clinic Jl. Sungai Bambu Raya 5, Tanjung (021) 4390 3355 P P P P P
Priok
RS Satya Negara Hospital & Clinic Jl. Agung Utara Raya, Blok A No.1 (021) 6471 5200 P P P
RSIA Hermina Podomoro Maternity & Children Jl. Danau Agung II, Blok E3 No. 28-30 (021) 640 4910 P P P P P
RSUD Koja Hospital IPD Only Jl. Deli No. 4 Tanjung Priok (021) 4393 8478 P P P P P
RS Royal Progress Hospital & Clinic Jl. Danau Sunter Utara Paradise I (021) 6400261 P

State/Province: Jambi

RS Asia Medika Jambi Hospital & Clinic Jl. Soekarno Hatta Pal Merah (0741) 573333 P P P P P P
RS St. Theresia Hospital & Clinic Jl. Dr. Sutomo No.19 (0741) 23119 P P P

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Barat

Bandung
Dr. Soeseno Hadi, M. Kes Practitioner Jl. Merdeka No 44 (022) 4202386 P
Klinik An-Nur Bandung Clinic - Not 24 Hours Jl. Setiabudi No. 63 (022) 203 1922 P P
Melinda Hospital Bandung Maternity & Children Jl. Pajajaran 46 Bandung (022) 4222788 P P P P P P
RS Advent Bandung Hospital & Clinic Jl. Cihampelas No.161 (022) 203 4386 P P P P P P
RS Al Islam Bandung Hospital & Clinic Jl. Sukarno Hatta No.644 (022) 756 3231 P P P
RS Immanuel Bandung Hospital & Clinic Jl. Kopo No 161 (022) 520 1656 P P P P P
RS Kebon Jati, Bandung Hospital & Clinic Jln. Kebonjati No. 152 (022) 603 1969 P P
RS Muhammadiyah Bandung Hospital & Clinic Jl. KH. Ahmad Dahlan No.53 (022) 730 1062 P P
RSB Limijati Maternity Only Hospital Jl. LL. RE Martadinata No.33 - 39 (022) 42077 70 P P P P
RSIA Hermina Pasteur-Bandung Maternity & Children Jl. dr. Djundjunan No. 107 (022) 6072 525 P P P P P
RSU Bungsu Hospital & Clinic JL. Veteran No. 6 (022) 431 550 P P P P P
RSU Pindad Bandung Hospital & Clinic Jl.Jend. Gatot Subroto, No. 517 (022) 732 1964 P P
Santosa Bandung Internasional Hospital & Clinic Jl. Kebonjati No. 38 (022) 4248333 P P P P P P
Hospital

Released: 12 May 2010, 1:53:56PM Page 8 of 21

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Barat

Bekasi
Bio Medi Centre Clinic - 24 Hours Jl. MH Thamrin Blok D15, Ruko (021) 8990 3220 P
Union-Lippo Cikarang
Clinic & RB Hosana Medika 5 Clinic - 24 Hours Jl.Cikarang Baru Raya,Ruko Elite Blok (021)8911 1431 P P P
3B No.74-77, Cikarang Baru
Clinic Renicha Putra Cikarang Clinic - 24 Hours Jl.Raya Cikarang Cibarusah, Lippo (021) 897 1852 P
Cikarang
Clinic Yayasan Mulya Medika Clinic - 24 Hours Jl. Raya Jati Mulya, Bekasi Timur (021) 820 3272 P P
Global Awal Bros Hospital Hospital & Clinic Jl. KH. Noer Ali Kav. 17-18, Kalimalang (021) 8885 5333 P P P P P
Klinik & RB Graha Bina Husada Clinic - 24 Hours Jl. Industri Selatan No. 1A Blok NN 3A, (021) 8983 6243 P P
Kawasan Industri Jababeka II
Klinik Annisa II Clinic - 24 Hours Jl. Raya Cibarusah No. 31 R, Komp. (021) 897 6189 P P
Ruko Point, Sukaresmi, Cikarang
Klinik Annisa III Clinic - 24 Hours Jl.Raya Cibarusah Blok A-5, Ruko (021) 899 09010 P P
Sentra Cikarang
Klinik Asyifa Husada Clinic - Not 24 Hours Perumahan Villa Mutiara Jaya, Blok N (021) 7021 7179 P P
78 No.12 Cibitung
Klinik Citra Medika I Pekayon Clinic - 24 Hours Jl. Pekayon Raya No. 6 (021) 8240 6922 P P
Klinik Citra Medika II Tm. Narogong Clinic - 24 Hours Jl. Taman Narogong Raya No. 7 (021) 8216390 P P
Klinik Citra Sehat Tambun Clinic - 24 Hours Perumahan Citra Villa Blok A-1/26, (021) 88370203 P
Tambun
Klinik Fajar Medika Clinic - Not 24 Hours Ruko MM2100, Depan Makro, Cibitung (021) 898 1162 P
Klinik Fikri Husada Clinic - Not 24 Hours Jl. Gardena Raya B6-32, Perum (021) 480 1285 P P
Harapan Baru, Regency
Klinik Harapan Sehat I Clinic - 24 Hours Jl. Teuku Umar No. 33, Cibitung (021) 88336674 P P
Klinik Harapan Sehat II Clinic - 24 Hours Ruko Perum Telaga Harapan Blok F (021) 88336674 P P
No. 16, Cikarang Barat
Klinik Harapan Sehat III Clinic - 24 Hours Perum Villa Mutiara Jaya Blok MB 16 (021) 88336674 P P
No. 07, Cibitung
Klinik Hosana Medica Cibitung Clinic - 24 Hours Teuku Umar No.19, Cibitung (021) 883 38414 P P
Klinik Hosana Medica Mangun Jaya Clinic - 24 Hours Jl. Mangun Jaya I Blok A No. 6, (021) 88363507 P P
Tambun
Klinik Hosana Medika Jababeka Clinic - 24 Hours Kws Industri Jababeka B8, Cikarang (021) 893 7941 P P
Klinik Indo Farma Clinic - 24 Hours Jl. Indo Farma I, Cikarang Barat (021) 88323971 P
Klinik Industri Medika (INTRIMED) Clinic - Not 24 Hours Ruko Mega Mall Blok C2, Kawasan (021) 8980734 P P
Industri MM-2100 Cibitung
Klinik Jaya Medika Clinic - Not 24 Hours Perum Permata Harapan Baru Ruko (021) 88988163 P P
Blok H-46, Medan Satria
Klinik Legenda Sehat Clinic - Not 24 Hours Jln. Zamrut Utara Blok U16 No.100, (021) 8260 0148 P
Kota Legenda
Klinik Meditama Clinic - 24 Hours Ruko Plaza Roxy B-11, Jl. Kasuari (021) 89835757 P
Raya, Cikarang Baru
Klinik Melviana Hospital & Clinic Jl. Saparua Raya No.239, Perumnas III (021) 880 7610 P
Bekasi
Klinik Mulya Medika II Clinic - 24 Hours Perum Gramapuri Blok D1 No. 5, (021) 88362481 P P
Cibitung
Klinik Niza Asyifa' Bersama 1 Clinic - 24 Hours Perumahan Telaga Harapan Blok E1/1, (021)891 09638 P
Cibitung
Klinik Niza Asyifa' Bersama 2 Clinic - 24 Hours Perumahan Villa Mutiara Jaya Blok (021) 68700672 P
M-85/9, Cibitung
Klinik Nugraha 1 Clinic - 24 Hours Perumahan Telaga Murni Blok C9/19, (021) 89106448 P
Cibitung
Klinik Nugraha 2 Clinic - 24 Hours Jl. Raya Taman Aster, Cibitung (021) 88339192 P
Klinik Pondok Gede Agung Clinic - 24 Hours Jl. Raya Hankam No. 58 C-D, Pondok (021) 846 4030 P P P
Gede
Klinik Prima Husada Tambun Clinic - Not 24 Hours Jl. Sultan Hasanudin No. 175, Tambun (021) 880 3966 P P
Klinik Sapta Mitra Bekasi Utara Clinic - 24 Hours Jl. KH.M.Tabrani Blok IA-IB, (021) 70266932 P P
Margamulya
Klinik Sapta Mitra Cikarang Clinic - Not 24 Hours Jl. Raya Cikarang-Cibarusah, Ruko (021) 8975369 P P
No. 39A Sukaresmi, Cikarang Selatan
Klinik Sehat Sejahtera Clinic - 24 Hours Jl. Raya Nusantara No. 2, Perumnas III (021) 883 49427 P
Klinik Trisa Clinic - Not 24 Hours Jl. Setiadarma II No.8, Tambun (021)8836 8863 P
Selatan, Tambun Selatan
Klinik Vita Insani Clinic - 24 Hours Jl. Nangka Raya B II No.24, Bekasi (021) 885 9988 P P
Barat
Klinik Wijaya Kesuma Clinic - 24 Hours Perumahan Taman Narogong Indah, (021) 8210779 P
Jl. Narogong Saksi Raya A Blok A-20
No. 1
Klinik Yayasan Bina Medika Clinic - 24 Hours Kp. Kongsi Rt. 02/II, Cikarang (021) 890 0050 P
Klinik Yayasan Karya Medika I Clinic - Not 24 Hours Jl. Ir. H. Juanda No.38C (021) 880 1293 P

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Barat

Klinik Yayasan Karya Medika III Clinic - Not 24 Hours Jl. Perjuangan No.30, Teluk Buyung (021) 885 1152 P
Klinik Yayasan Karya Medika IV Clinic - Not 24 Hours Jl. Narogong Km 11, Bantar Gebang (021) 825 4629 P
Klinik Yayasan Karya Medika V Clinic - Not 24 Hours Ruko Harko Jababeka, Cikarang (021) 8983 2569 P
Klinik&Apotek Guci Medika Clinic - 24 Hours Jl. Pramuka No. 79, Rawa Lumbu (021) 82433158 P P
Klinik&Apotik Sapta Mitra Bekasi Clinic - 24 Hours Jl. Raya Pondok Timur Ruko gading (021) 82602180 P P
Timur Mas 8F-G, Pengasinan - Rawa Lumbu
Klinik&RB Hosana Medika Serang Clinic - Not 24 Hours Jl. Raya Serang Cibarusah Kp. Bumi (021) 89952613 P P
Baru Sari RT. 07/04, Desa Sukaragam, Kec
Serang Baru
PBDS & RSB Juwita Maternity Only Hospital Jl. M. Hasibuan No. 78 (021) 8829590 P P P
RB & Klinik Annisa IV Clinic - 24 Hours Jln. Raya Cibarusah Raya No. 63, Kp. (021) 8995 4434 P P
Pasir Randu RT. 011/006, Desa
Sukasari, Sergangbaru
RB&Klinik Indosehat 2003 Maternity Only Hospital Jl. Beruang Raya HI/185-187, Cikarang (021) 89834420 P P P
RB&Klinik Ratna Clinic - 24 Hours Jl. Ratna No. 75 RT. 005/09 Jati (021) 84998134 P
Kramat
RB&Klinik Ridhoka Salma Hospital & Clinic Jl. Imam Bonjol No. 7, Kp. Gardu (021) 89116527 P P
Sawah, Cikarang Barat
RB&Klinik Yayasan Angelika Clinic - 24 Hours Jl. Bossih Raya Blok E5 No. 12-13, (021) 88330750 P P
Medika Pondok Tanah Mas - Cibitung
RB&Praktek Bersama Kartika Clinic - 24 Hours Pasar Sentral Lippo Cikarang, Blok (021) 98172736 P P
Husada ESA 2.3.5 Jalan Utama B II Cibarusah
Cikarang
RS Amanda Serang Hospital & Clinic Jl. Serang No. 83, Cikarang Selatan (021) 8971643 P P P P P
RS Ananda Bekasi Hospital & Clinic Jl. Sultan Agung No.173 (021) 885 4338 P P P P P
RS Annisa Bekasi Hospital & Clinic Jl. Cikarang Baru No.31, Lemah Abang (021) 890 4165 P P P P P
RS Bhakti Husada Cikarang Hospital & Clinic Jl. RE. Martadinata, Cikarang (021) 890 0530 P P P
RS Bhakti Kartini Bekasi Hospital & Clinic Jl. Kartini No.11 (021) 880 1954 P P P P P
RS Budi Lestari Hospital & Clinic Jl. KH Noer Ali No.2, Depan Perumnas (021) 8893486 P P P
II
RS Citra Harapan Hospital & Clinic Jl. Raya Harapan Indah Kaw. Sentra (021) 88870606 P P P P P
Niaga No. 3-5, Harapan Indah, Medan
Satria
RS Graha Juanda Hospital & Clinic Jl. Ir. H. Juanda No. 326 (021) 881 1832 P P P
RS Hosana Medika Bekasi Hospital & Clinic Jl. Pramuka No. 12 RT 004/002, Kel (021) 8221570 P P P P P
Sepanjang Jaya, Kec Rawa Lumbu
RS Hosana Medika Lippo Cikarang Hospital & Clinic Ruko Thamrin Blok C No.3, Lippo (021) 897 2472 P P P P P
Cikarang
RS Karya Medika Hospital & Clinic Jl.Raya Imam Bonjol No. 9B, Cikarang (021) 890 3003 P P P P P
Barat
RS Medika Cikarang Hospital & Clinic Jl. Ry Ind Pasirgombong, (021) 890 4160 P P P
Jababeka-Cikarang
RS Medirossa Hospital & Clinic Jl. Industri Tegal Gede, Cikarang (021) 89833216 P P P P P
Selatan
RS Mekar Sari Hospital & Clinic Jl. Mekar Sari No.1 (021) 880 1891 P P P
RS Miracle Medica Cikarang Hospital & Clinic Jl. KH. Dewantara No. 33 Pilar, (021) 89116177 P P P P P
Cikarang Utara
RS Mitra Keluarga Bekasi Barat Hospital & Clinic Jl. Jend Ahmad Yani (021) 885 3333 P P P P P P
RS Mitra Keluarga Bekasi Timur Hospital & Clinic Jl. Pengasinan Margahayu (021) 881 7777 P P P P P P
RS Permata Bekasi Hospital & Clinic Jl. Legenda Raya No. 9 Mustika Jaya (021) 8254748 P P P P P
RS Permata Bunda Cibitung Hospital & Clinic J. Gramapuri I Blok CI No. 8-10, (021) 88328001 P P P P
Perumahan Gramapuri, Taman sari,
Wanasari Cibitung
RS Ratna Husada Hospital & Clinic Jl. Pramuka no.12 Narogong (021) 822 1571 P P P
RS Rawa Lumbu Hospital & Clinic Jl. Dasa Darma No. 20-23, Rawa (021) 82422512 P P P P P
lumbu
RS Sentosa Hospital & Clinic Jl. Pahlawan No. 60, Duren Jaya (021) 880 6140 P P P
RS. Harapan Keluarga Hospital & Clinic Jl. Kasuari Raya Kav. 1A&B, Kota (021) 8983 5838 P P P P P
Jababeka, Cikarang Baru
RS. St. Elisabeth Bekasi Hospital & Clinic Jl. Raya Narogong No. 202, Kemang (021) 82430101 P P P P P
Pratama, Bojong Rawalumbu
RSB Ibu Soedibyo Maternity Only Hospital Jl. KH Agus Salim No.100 B (021) 880 2435 P P P
RSB Setia Maternity Only Hospital jl. Raya Serang Cibarusah No.41 (021) 897 1240 P P P
RSB Taman Harapan Baru Maternity Only Hospital Jl. Taman Harapan Baru Raya R-1 (021) 8887 1202 P P P
No.20, Kel. Pejuang, Kec. Medan
Satria
RSIA Amanda Cikarang Hospital & Clinic Jl. Raya Industri No. 36, Cikarang (021) 89110011 P P P P P
Utara
RSIA Anna Hospital & Clinic Jl. Pekayon Raya No. 36 (021) 8243 2211 P P P P P

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Barat

RSIA Bella Maternity & Children Jl. Ir H Juanda No 141 (021) 880 1775 P P P
RSIA Dokter Adam Talib Hospital & Clinic Jl Raya Teuku Umar No. 25, Cikarang (021) 88332304/6 P P P P P
Barat
RSIA Hermina Bekasi Maternity & Children Jl. Kemakmuran No 39, Margajaya (021) 884 2121 P P P P P
RSIA Jati Sampurna Hospital & Clinic Jl. Studio ANTV, Jati sampurna (021) 8541457 P P P P P
RSIA Jatimulya Medical Centre Maternity & Children Jl. Jatimulya Raya No.14 (021) 8203 785 P P P
RSIA Sri Tina Maternity & Children Jl. Imam Bonjol No. 80, Cikarang Barat (021) 8900579 P P P P P
RSIA Yayasan Karya Medika II Maternity & Children Jl. Hasanuddin No.63, Tambun (021) 8832 4366 P P P P P
RSU Kartika Husada Hospital & Clinic Jl. Raya Mangun jaya, Kp. Rukem (021) 88327281 P P P P
Tambun
Siloam Hospitals Cikarang Hospital & Clinic Jl. MH. Thamrin Kav. 105, Lippo (021) 897 2187 P P P P P P
Cikarang

Bogor
Klinik Amanah Clinic - 24 Hours Jl. Raya Cibanteng Babengket, (0251) 620 880 P
Ciampea
Klinik Amanda Medika Clinic - 24 Hours Jl.M. Nasir No.21,Bojong Kolor,G. Putri (021) 8240 3372 P
Klinik Dr. Sutadi Clinic - 24 Hours Jl. Veteran No. 48C, Bogor (0251) 324 460 P
Klinik Dr. Sutadi II Clinic - 24 Hours Jl. Raya Pancasan Tonggoh No. 40, (0251) 330702 P
Bogor
Klinik Insani Bogor Clinic - 24 Hours Jl. Pahlawan 73 B Citeureup (021) 87942723 P P
Klinik Lido & Apotik Clinic - 24 Hours Ruko Villa Mutiara Lido No. 10, (0251) 222 666 P
Cigombong
Klinik Medika I - MKGR Clinic - 24 Hours Jl. Raya Wangun No. 363, Ciawi (0251) 240 379 P
Klinik Medika III Clinic - 24 Hours Jl. Raya Leuwiliang No. 79, Bogor (0251) 8641 056 P
Klinik Medissa Clinic - 24 Hours Jl. MayJend. HE Sukma no. 12, (0251) 245 536 P
Bantarjati
Klinik Medista Bogor Clinic - 24 Hours Ruko Warung Jambu Blok A - 2, (0251) 385 976 P
Bantarjati
Klinik Nurdin Medika Clinic - Not 24 Hours Jl.H. Ashari No.22 Cibinong (021) 8240 3372
Klinik Prima Clinic - 24 Hours Jl. Pahlawan No. 81, Bondongan (0251) 374860 P
Klinik Siba Clinic - 24 Hours Jl. Sindang Barang No. 159 A (0251) 373 323 P
Klinik Sudirman Clinic - 24 Hours Jl. Raya Jend.Sudirman No.38 D, (0251) 314 940 P
Bogor
RS Azra Bogor Hospital & Clinic Jl. Raya Pajajaran 219 (0251) 8318 456 P P P P P P
RS Bina Husada, Cibinong Hospital & Clinic Jl. May.Oking Jajaatmaja, Cibinong (021) 875 3422 P P P P P
RS Bogor Medical Center Hospital & Clinic Jl. Pajajaran Indah V No. 97 (0251) 8390 435 P P P P P P
RS Islam Bogor Hospital & Clinic Jl. Perdana Raya No. 22 (0251) 8316 822 P P P P
RS Karya Bhakti Hospital & Clinic Jl. Dr. Sumeru No. 120 (0251) 8312 292 P P P P P
RS MH Thamrin Cileungsi Hospital & Clinic Jl. Raya Narogong KM.16 Limus (021) 823 5052 P P P
Nunggal, Cileungsi
RS PMI Bogor Hospital & Clinic Jl. Raya Pajajaran, PO. Box 59 (0251) 8324 080 P P P P
RSIA Citra Insani Maternity & Children Jl. Raya Parung No.242 Lebakwangi, (0251) 8611507 P P P P P
Pemagarsari
RSIA Hermina Bogor Maternity & Children Jl. Ring Road - I Kav. 23,25,27, Perum. (0251) 8328 222 P P P P P
Taman Yasmin Bogor
RSIA Mary Cileungsi Hijau Hospital & Clinic Jl. Ry Narogong Km. 21, Cileungsi (021) 8249 2222 P P P P P

Cianjur
RSUD Cianjur Hospital & Clinic Jl. Rumah Sakit No. 1 (0263) 261 026 P P

Cibinong
RSIA Trimitra Maternity & Children Jl. Raya Jakarta-Bogor KM. 43 (021) 8763055 P P P P P

Cibubur
Holistic Care Dental Clinic Clinic - Not 24 Hours Little China Blok JB 06, Legenda (021) 8230991 P
Wisata Cibubur
Klinik Artha Sari Medika Clinic - 24 Hours Jl. Alternatif No. 41 Cibubur (021) 8459 1048 P
Klinik Yadika Cibubur Clinic - 24 Hours Jl. Lapangan No.9 Pekayon, Cibubur (021) 871 1515 P P
RS MEILIA CIBUBUR Hospital & Clinic Jl. Alternatif Cibubur, Cileungsi Km. 1 021- 8444 444 P P P P P P
RSIA & Klinik Spesialis Permata Hospital & Clinic Jl. Alternatif Cibubur-Cileungsi No.6A (021) 845 8806 P P P P P
Cibubur

Released: 12 May 2010, 1:53:56PM Page 11 of 21

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Barat

Cikampek
Klinik AQMA Cikampek Clinic - 24 Hours Jl. Stasiun no. 93 Cikampek (0264) 319 307 P P
Klinik Keluarga Graha Medis Clinic - 24 Hours Jl. A. Yani No. 51, Cikampek (0264) 310 101 P P
Klinik Putra Medika Cikampek Clinic - 24 Hours Jl. Ir. H. Juanda No. 19, Sukasari (0264) 301 652 P
RS Karya Husada Hospital & Clinic Jl. Jend. A. Yani No. 98, Cikampek (0264) 316 188 P P P

Cimahi
RS Mitra Kasih Hospital & Clinic Jl. Raya Cibabat No. 341 (022) 665 4852 P P P P P

Cirebon
RS Mitra Plumbon Hospital & Clinic Jl. Raya Plumbon KM. 11 (0231) 323100 P P P P P
RS Pelabuhan Cirebon Hospital & Clinic Jl. Sisingamangaraja No. 45 (0231) 205 657 P P P
RS Pertamina Cirebon Hospital & Clinic Jl. Patra Raya Klayan (0231) 224646 P P
RS Putera Bahagia CIREBON Hospital & Clinic Jl. Ciremei Raya No. 114, Perumnas (0231) 207351 P P P P P
RSIA Sumber Kasih Cirebon Maternity & Children Jl. Siliwangi 135 (0231) 203 815 P P P P P

Depok
Hospital Cinere Hospital & Clinic Jl. Maribaya Blok F2, (021) 754 5488 P P P P
Cinere-Sawangan
Klinik Medisina Clinic - 24 Hours Jl. Muhtar No. 32 - 34, Sawangan (0251) 611 054 P
Klinik Naura Medica Clinic - 24 Hours Jln. Kemakmuran Raya No. 37, Depok (021) 7782 4756 P
II Tengah
RS Harapan Depok Hospital & Clinic Jl. Pemuda No.10 (021) 777 3817 P P
RS Mitra Keluarga Depok Hospital & Clinic Jl. Margonda Raya, Pancoranmas (021) 7721 0700 P P P P P P
RS Sentra Medika Cisalak Hospital & Clinic Jl. Raya Bogor Km. 33, Cisalak (021) 874 3790 P P P P
RS Tugu Ibu Cimanggis Hospital & Clinic Jl. Raya Bogor Km 29, Cimanggis (021) 8710870 P P P P P
RSIA Graha Permata Ibu Hospital & Clinic Jl. KHM. Usman No. 168, Kukusan (021) 7778899 P P P
RSIA Hasanah Graha Afiah Hospital & Clinic Jl. Raden Saleh No. 42 (021) 77826267 P P P P P
RSIA Simpangan Depok Hospital & Clinic Jl. Raya Bogor KM. 36 Sukamaju, (021) 8747620 P P P
Sukmajaya
RSIA Tumbuh Kembang Maternity & Children Jl Raya Bogor Km. 31 No.23, Pal (021) 871 2300 P P P
Sigunung - Cimanggis
RSU Bhakti Yudha Depok Hospital & Clinic Jl. Raya Sawangan Depok (021) 752 0082 P P P P P
RSU Bunda Margonda Hospital & Clinic Jl. Margonda Raya No. 28, Pondok (021) 78890551 P P P P P
Cina
RSU Hermina Depok Maternity & Children Jl. Raya Siliwangi No. 50, Pancoran (021) 772 02525 P P P P P
Mas

Karawang
Klinik & RB Wadas Medika Clinic - 24 Hours Jl. Raya Buahaseum No. 63, (0267) 510999 P P P P
Lemahabang-Wadas
Klinik Ananda Karawang Clinic - Not 24 Hours Ruko Resinda F3/10 (0267) 4651056 P P
Klinik AQMA Karawang Clinic - 24 Hours Jl. Surotokunto No.17, Johar - (0267) 401 624 P
Karawang
Klinik CITO Karawang Clinic - Not 24 Hours Jl. Kertabumi No.29 (0267) 410 173 P P
Klinik Mitra Sehat Karawang Clinic - Not 24 Hours Jl. Raya Kosambi Curug, No. 31, Klari (0267) 432 526 P P
Klinik Purwa Medika Karawang Clinic - 24 Hours Jl. Raya Tamelang No. 53, Mekarjaya (0267) 433 653 P P
Klinik&RB Fikri Medika Hospital & Clinic Jl. Raya Kosambi, Telaga Sari, Ds. (0267) 433636 P P P P
Blendung
RS Bayukarta Karawang Hospital & Clinic Jl. Kertabumi No 44 (0267) 401 818 P
RS Citra Sari Husada Hospital & Clinic Jl. Raya Kosambi, Telaga Sari KM. 3, (0267) 437507 P P P P P
Klari
RS Dewi Sri Karawang Hospital & Clinic Jl. Arief Rahman Hakim, No. 1A (0267) 402 855 P P P P
RS Islam Karawang Hospital & Clinic Jl. Pangkal Perjuangan KM. 2 (0267) 414520-5 P P P P P
(By-Pass)
RSU AQMA Hospital & Clinic Jln. Raya Ciselang, Cikampek Utara (0264) 8386 830 P P
RSU Fikri Medika Hospital & Clinic Jl. Raya Kosambi, Telagasari KM. 3, (0267) 861 5555 P P P P P
Klari
RSU Proklamasi Rengasdengklok Hospital & Clinic Jl. Raya Rengasdengklok, Km.2 (0267) 482 192 P P

Released: 12 May 2010, 1:53:56PM Page 12 of 21

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Barat

Purwakarta
Klinik AQMA Plered Clinic - 24 Hours Jl. Anjun No. 96, Plered (0264) 270 830 P
Klinik AQMA Purwakarta Clinic - 24 Hours Jl. Ibrahim Singadilaga No. 14, (0264) 200 377 P
Purwakarta
Klinik&Apotik KOPINDOSAT Clinic - Not 24 Hours Jl. RE. Martadinata No. 39 0264-202382 P P
RS Efarina Etaham Hospital & Clinic Jl. Bungur Sari No. 1 (0264) 219168 P P P P P

Subang
Klinik AQMA Subang Clinic - 24 Hours Jl. Compreng No. 25, Pusaka Jaya (0260) 552 195 P
RS II PTPN VIII Subang Hospital & Clinic Jl. Otto Iskandardinata No. 1 (0260 ) 411 632 P P P

Sukabumi
Klinik Al - Ikhlas Clinic - 24 Hours Jl. Raya Siliwangi No. 407, Cicurug (0266) 733 033 P
Klinik Citra II Clinic - 24 Hours Jl. Surya Kencana Pamuyuran no. 12, (0266) 532 593 P
Cibadak
RS Bhakti Medicare Hospital & Clinic Jl. Raya Siliwangi No. 186B, Cicurug (0266) 731555 P P P P P
RS Hermina Sukabumi Hospital & Clinic Jl. Raya Sukaraja (0266) 9100989 P P P P P
RS Islam Assyifa Sukabumi Hospital & Clinic Jl. Jend. Sudirman No. 3 (0266) 222 663 P P P
RS Kartika Medical Center Hospital & Clinic Jl. Jendral ahmad Yani No. 18 A (0266) 6250902 P P P P P
RS. Betha Medika Hospital & Clinic Jl. Raya Cisaat No. 595 (0266) 224128 P P P P P

Sumedang
RS Pakuwon Sumedang Hospital & Clinic Jln. Raden Dewi Sartika No. 17 (0261) 2108 34 P P P P P
RSUD Sumedang Hospital & Clinic Jl. Geusan Ulun No. 41 (0261) 201021 P P P P P

Tasikmalaya
RS Jasa Kartini Hospital & Clinic Jln. Otto Iskandardinata No. 15 (0265) 331 641 P P

State/Province: Jawa Tengah

Cepu
RS PKU Muhammadiyah Cepu Hospital & Clinic Jl. Ronggolawe No. 137 (0296) 421 727 P P P P P

Cilacap
RS Pertamina Cilacap Hospital & Clinic Jl. Setiabudi, Tegal kamulyan (0282) 531 633 P P
RSI Fatimah Cilacap Hospital & Clinic Jl. Ir. Juanda 20 (0282) 545 213 P P P

Gombong
RS Palang Biru Gombong Hospital & Clinic Jl. Kartini no 37 (0287) 471 290 P P P P P

Klaten
RS Islam Klaten Hospital & Clinic Jl. Raya Yogya Solo Km 2 (0272) 322 252 P P P P P

Kudus
RS Mardi Rahayu Kudus Hospital & Clinic Jl. R. Agil Kusumadiya, No. 110 (0291) 434 707 P P P P P

Magelang
RS Harapan Magelang Hospital & Clinic Jl. P Senopati No. 11 (0293) 364 033 P P P P P
RSIA Gladiool Maternity & Children Jl. Kenanga No. 4-6 (0293) 362702 P P P P P

Pati
Keluarga Sehat Hospital Hospital & Clinic Jl. P. Sudirman No. 9, Margorejo (0295) 386111 P P P P P

Pekalongan
RS Siti Khodijah Pekalongan Hospital & Clinic Jl. Bandung 39 - 47 Pekalongan (0285) 422 845 P P P
Klinik Diagnostik "CITO" Clinic - Not 24 Hours Jl. KH. Mas Mansyur No.33 (0285) 422 458 P
Pekalongan

Released: 12 May 2010, 1:53:56PM Page 13 of 21

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Tengah

Pemalang
RSU Santa Maria Pemalang Hospital & Clinic Jl. Pemuda No. 24 (0284) 321251 P P P P P

Purwodadi
RS Panti Rahayu Purwodadi Hospital & Clinic Jl. R Suprapto 06 (0292) 421087 P P P P P
RS Permata Bunda Purwodadi Hospital & Clinic Jl. Hayam Wuruk No. 24, Grobogan (0292) 422839 P P P P P

Purwokerto
RS St. Elisabeth Purwokerto Hospital & Clinic Jl. Jend. Gatot Subroto No. 44, (0281) 631 761 P P P
Purwokerto
RSU Bunda Purwokerto Hospital & Clinic Jl. Pramuka 249 (0281) 635 424 P P P P

Rembang
RSU Rembang Hospital & Clinic Jl. Taman Bahagia No. 16 Rembang (0295) 691 444 P P P

Salatiga
RSU Ananda Salatiga Hospital & Clinic Jl. Ki Penjawi 7 (0298) 324141 P P P P P
RSU Puri Asih Salatiga Hospital & Clinic Jl. Jendral Sudirman No. 169 (0298) 323209 P P P P P

Semarang
Klinik Bina Sehat Clinic - 24 Hours Jl. Kalimas Raya No.29 (024) 354 9000 P P
Klinik Diagnostik " CITO" Setiabudi Clinic - Not 24 Hours Jl. Setiabudi G 62 K-L (024) 7461645 P
Klinik Diagnostik " CITO" Solo Clinic - Not 24 Hours Jl. Dr. Rajiman 349 (0271) 714 455 P
Klinik Puri Husada Clinic - Not 24 Hours Jl. Puri Anjasmoro H5/45A (024) 760 0360 P P
RS Banyumanik Hospital & Clinic Jl. Bina Remaja 61 (024) 747 1519 P P
RS Hermina Pandanaran-Semarang Hospital & Clinic Jl.Pandanaran No.24 (024) 8442525 P P P P P
RS Islam Sultan Agung Semarang Hospital & Clinic Jl. Raya Kaligawe Km. 4 (024) 658 0019 P P
RS Panti Wilasa "Dr. Cipto" Hospital & Clinic Jl. Dr. Cipto No. 50 (024) 354 6040 P P P
RS Panti Wilasa Citarum Hospital & Clinic Jl. Citarum No. 98 (024) 3542224 P P P P
RS Permata Medika Semarang Hospital & Clinic Jl. Mr. Moch Ichsan 93 -97, Ngaliyan (024) 762 5005 P P P P P
RS Roemani Muhammadiyah Hospital & Clinic Jl. Wonodri No. 22 (024) 844 4623 P P P P P
Semarang
RS St. Elisabeth Semarang Hospital & Clinic Jl. Kawi No. 1 (024) 831 0076 P P P P P
RS Telogorejo Hospital & Clinic Jl. KH. Ahmad Dahlan (024) 844 6000 P P P P P
Klinik Diagnostik "CITO" Dr. Cipto Clinic - Not 24 Hours Jl. Dr. Cipto 14A (024) 351 5374 P
Klinik Diagnostik "CITO" Indraprasta Clinic - Not 24 Hours JL. Indraprasta 81A (024) 355 6853 P

Solo
RS Dr. Oen Solo Baru Hospital & Clinic Komp. Perumahan Solo Baru, (0271) 620 220 P P P P P P
Kec.Grogol. Kab. Sukoharjo
RS Panti Waluyo Hospital & Clinic JL.Jend. A. Yani No.1-2 (0271) 712 077 P P P P P

Sukoharjo
RS Nirmala Suri Hospital & Clinic Jl. Raya Solo Sukoharjo, Km. 9 (0271) 593 814 P P P

Surakarta
RS Dr. Oen Surakarta Hospital & Clinic Jl. Brigjen Katamso No. 55, Surakarta (0271) 643 139 P P P P P
RS Islam Surakarta (YARSIS) Hospital & Clinic Jl. Jend. A. Yani Pabelan, Surakarta (0271) 710 571 P P
RS Kasih Ibu Surakarta Hospital & Clinic Jl. Slamet Riyadi 404, Surakarta (0271) 714 422 P P P

Tegal
Klinik Diagnostik "CITO" Tegal Clinic - Not 24 Hours Jl. Gajahmada No. 79 (0283) 353 402 P
RS Mitra Keluarga Tegal Hospital & Clinic Jl. Sipelem No.4, Kemandungan Tegal (0283) 394 999 P P P P P
RSI Harapan Anda Hospital & Clinic Jl. Ababil No.42, Tegal (0283) 358 244 P P P

Temanggung
RS Ngesti Waluyo Hospital & Clinic Jl. Parakan, Kab. Temanggung (0293) 596 008 P P P
RS PKU Muhammadiyah Hospital & Clinic Jl. Raya Kedu KM. 2, Kalisat (0293) 596704 P P
Temanggung

Released: 12 May 2010, 1:53:56PM Page 14 of 21

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PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Timur

Banyuwangi
RS Al Huda Banyuwangi Hospital & Clinic Jl. Diponegoro No. 65, Genteng (0333) 8420333 P P P P P
RS Islam Fatimah Banyuwangi Hospital & Clinic Jl. Jember No.25, Kabat - Banyuwangi (0333) 421 451 P P P

Bojonegoro
RSUD Dr. R. Sosodoro Hospital & Clinic Jl. Dr. Wahidin No. 40 (0353) 881193 P P P P P
Djatikoesoemo Bojonegoro

Gresik
RS Petrokimia Gresik Hospital & Clinic Jl. Jendral Ahmad Yani No. 69 (031) 3978658 P P P P P
RS Semen Gresik Hospital & Clinic Jl. RA. Kartini No. 280 (031) 397 3477 P P P P P

Jember
RS Bina Sehat Hospital & Clinic Jl. Jaya Negara No. 7 (0331) 422701 P P P P P
RS Perkebunan / PTPN X Jember Hospital & Clinic Jl. Bedadung No 2 (0331) 487 104 P P P P
RSU Kaliwates Jember Hospital & Clinic Jl. Diah Pitaloka No. 1 (0331) 483505 P P P P P

Kediri
RS Baptis Kediri Hospital & Clinic Kotak Pos 1, Jl Brigjen Pol IBH (0354) 684 172 P P P P
Pranoto

Lumajang
RS Wijaya Kusuma Lumajang Hospital & Clinic Jl. A. Yani No. 149 (0334) 891325 P P P P P

Madiun
RS Santa Clara Madiun Hospital & Clinic Jl. Biliton No. 15 (0351) 462 688 P P P P P
RSI Siti Aisyah Madiun Hospital & Clinic Jl. Mayjend Sungkono No. 38 (0351) 464822 P P P P P

Madura
RS Larasati Hospital & Clinic Jl. Mandilaras No. 74, Pamekasan (0324) 328305 P P P P P

Malang
Apotik & Klinik Griya Bromo Clinic - Not 24 Hours Jl. Bromo No. 7 (0341) 341818 P P
RS Baptis Batu Hospital & Clinic Jl. Raya Tlekung No. 1 Junrejo, Batu (0354) 594 161 P P
RS Islam Aisyiyah Malang Hospital & Clinic Jl. Sulawesi 16 (0341) 326 773 P P P
RS Islam Malang Hospital & Clinic Jl. Mayjen Haryono 139 (0341) 551356 P P P P P
RS Manu Husada Malang Hospital IPD Only Jl. Sultan Agung No. 12 (0341) 320 376 P P P P P
RS Marsudi Waluyo Singosari Hospital & Clinic Jl. Raya Mondoroko Km.9 (0341) 458 974 P P P P P
RS Panti Nirmala Hospital & Clinic Jl. Kebalen Wetan No.8 (0341) 362 459 P P P P P
RS Panti Waluya Sawahan Malang Hospital IPD Only Jl. Nusa Kambangan 56 (0341) 362 017 P P
RS Wava Husada Hospital & Clinic Jl. Panglima Sudirman 99 A, Kepanjen (0341) 393000 P P P P P
RSIA Hermina Maternity & Children Jl. Tangkuban Perahu No. 33 (0341) 325082 P P P P P
Tangkubanprahu-Malang
RSIA Melati Husada Hospital & Clinic Jl. Kawi No. 32 (0341) 325249 P P P P P
RSU. Lavalette Malang Hospital & Clinic Jl. W.R. Supratman No. 10 (0341) 470 805 P P P P P

Mojokerto
RS Gatoel Mojokerto Hospital & Clinic Jl. R. Wijaya 56 Mojokerto (0321) 322 329 P P P
RS Kartini Mojosari Hospital & Clinic Jl. Airlangga 137 Mojosari (0321) 592261 P P P P P
RS Reksa Waluya Hospital & Clinic Jl. Mojopahit No.442 Mojokerto (0321) 322 170 P P P P P
RS. Emma Mojokerto Hospital & Clinic Jl. Raya Ijen No. 67 (0321) 328 737 P P P P P
RSI Arofah Mojosari Hospital & Clinic Jl. Gajah Mada No. 1 Mojosari (0321) 596 900 P P P P P

Pasuruan
RSI Masyithoh Bangil Hospital & Clinic Jl. A. Yani No. 6, Bangil (0343) 741018 P P P P

Probolinggo
RS Dharma Husada Probolinggo Hospital & Clinic Jl. Soekarno Hatta No. 10 (0335) 422176 P P P P P

Released: 12 May 2010, 1:53:56PM Page 15 of 21

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PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Jawa Timur

Sidoarjo
Klinik Citra Gading Medika Clinic - 24 Hours Jl. Brigjen Katamso A408-409, Rewwin (031) 8679727 P
RS Anwar Medika Hospital & Clinic Semawut Balongbendo, Sidoarjo (031) 897 2052 P P P P P
RS Delta Surya Hospital & Clinic Jl. Pahlawan No.9 (031) 896 2531 P P P P
RS Mitra Keluarga Waru Hospital & Clinic Jl. Jend S Parman No. 8 Waru (031) 8542111 P P P P P P
RS Siti Khodijah Sepanjang Hospital & Clinic Jl. Pahlawan 260 Sepanjang (031) 788 1130 P P P P
RSI Siti Hajar Sidoarjo Hospital & Clinic Jl. Raden Patah No. 70 (031) 8921 233 P P P

Surabaya
Klinik dr. Ipung Clinic - Not 24 Hours Jl. Ngagel Jaya Tengah 115 (031) 5024612 P
Klinik Sentra Medika Surabaya Clinic - 24 Hours Jl. Raya Tenggilis No. 91-93, Surabaya (031) 8438777 P
Pramita Utama Diagnostic Centre Clinic - Not 24 Hours Jl. Dharmawangsa 66 (031) 502 0552 P P
Surabaya
RS Adi Husada Undaan Wetan Hospital & Clinic Jl. Undaan Wetan No. 40-44 (031)5321256-59 P P P P P
RS Darmo Surabaya Hospital & Clinic Jl. Raya Darmo 90 (031) 567 6253 P P P
RS Islam A.Yani Surabaya Hospital & Clinic Jl. Jend. A. Yani No. 2-4 (031) 8284505 P P P P P
RS Islam Jemursari Surabaya Hospital & Clinic Jl. Raya Jemur Sari No. 51-57 (031) 8471877 P P P P P
RS Katolik Vincentius A Paulo/RKZ Hospital & Clinic Jl. Diponegoro 51 (031) 567 7562 P P P P
Surabaya
- Clinic located at Jl. Ciliwung 42 with cashless services available Monday to Saturday (8:00 AM - 11:00 AM) only. After hours outpatient services
refered to ER
RS Mitra Keluarga Surabaya Hospital & Clinic Jl. Satelit Indah II, Darmo Satelit (031) 734 5333 P P P P P P
Surabaya
RS Spesialis Husada Utama Hospital & Clinic Jl. Prof. Dr. Moestopo No. 31-35 (031) 5018335 P P P P P
RS Surabaya Internasional Hospital & Clinic Jl. Nginden Intan Brt Bl.B (031) 599 3211 P P P P P P
RS William Booth Surabaya Hospital & Clinic Jl. Diponegoro, No 34 (031) 567 8917 P P P P P
RS. Muji Rahayu Hospital & Clinic Jl. Manukan Wetan 68 - 68A (031) 740 4132 P P P
RSAL Dr. Ramelan Hospital IPD Only Jl. Gadung No.1 (031) 843 8153 P
RS PHC Surabaya Hospital & Clinic Jl. Prapat Kurung Selatan No. 1, (031) 329 4801 P P P P P
Tanjung Perak
Siloam Hospitals Surabaya Hospital & Clinic Jl. Raya Gubeng No. 70, Surabaya (031) 503 1333 P P P P P P

State/Province: Kalimantan Barat

Pontianak
RS ProMedika Pontianak Hospital & Clinic Jl. Gusti S. Lelanang Blok EA No. 2-5, (0561) 7390 82 P P P P
Pontianak Mall
RSIA Anugerah Bunda Khatulistiwa Hospital & Clinic Jl. A. Yani I (0561) 581818 P P P P P
RSU Santo Antonius Pontianak Hospital & Clinic Jl. Wahid Hasyim No. 294 (0561) 732 101 P P P
RSUD Dr. Soedarso Hospital & Clinic Jl. Adi Sucipto (0561) 737 701 P P P

Singkawang
RS Vincentius Singkawang Hospital & Clinic Jl. Pangeran Diponegoro No. 5 (0562) 631 008 P P P P
RSU Harapan Bersama Hospital & Clinic Jl. P Belitung No. 61 (0562) 631791 P P P P P P

State/Province: Kalimantan Selatan

Balikpapan Baru
Panacea Clinic Clinic - Not 24 Hours Komp.Mal Fantasi Blok AB 2 No.18-20 (0542) 877898 P P P P
- Please Note: You must telephone Global Assistance before arrival at this Hospital so arrangements can be made

Banjarmasin
Klinik Spesialis Sari Mulia Clinic - Not 24 Hours Jl. P. Antasari No. 139 B, Banjarmasin (0511) 325 4341 P
Banjarmasin
RS Islam Banjarmasin Hospital & Clinic Jl. Letjend S. Parman, Gg. Purnama (0511) 3354896 P P P
No.1
RS Sari Mulia Banjarmasin Hospital & Clinic Jl. P. Antasari No. 139, Banjarmasin (0511) 325 2570 P P P P P
RSK Bedah Banjarmasin Siaga Hospital & Clinic Jl. A. Yani No. 149 KM. 3.5 (0511) 325 3111 P

Released: 12 May 2010, 1:53:56PM Page 16 of 21

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Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Kalimantan Selatan

Tanjung
RS Pertamina Tanjung Hospital & Clinic Jl. Gas Murung Pudak (0526) 2022 550 P P P P

State/Province: Kalimantan Timur

Balikpapan
Balikpapan Dental Health Center Dental Clinic Jl. Jend. Sudirman Komp. Pantai Mas (0542) 426 461 P P
Permai A/28
RS Balikpapan Baru Hospital & Clinic Jl. MT. Haryono, Komp. Balikpapan (0542) 877 330 P P P P P
Baru, Blok A-3A No 7-9
RS Balikpapan Husada Hospital & Clinic Jl. M.T Haryono No.9 Ring Road (0542) 720 6509 P P P P P
Balikpapan
RS Harapan Mulia Balikpapan Hospital & Clinic Jl. Wiluyo Puspoyudo No. 26-30 (0542) 441572 P P P
RS Pertamina Balikpapan Hospital & Clinic Jl. Jend Sudirman No.1 (0542) 734020 P P P P P P P
RS Restu Ibu Balikpapan Hospital & Clinic Jl. A. Yani No. 85 (0542) 422304 P P P
RSIA Permata Hati Balikpapan Maternity & Children Jl. Imam Bonjol No. 01, Balikpapan (0542) 413 932 P P P P

Bontang
RSUD Taman Husada Bontang Hospital & Clinic Jl. S Parman No. 1 (0548) 3036990 P P P P P

Kutai Kartanegara
Klinik Maju Sejahtera Handil Clinic - 24 Hours Jl. Moh. Hatta No. 17, Handil 3 (0541) 6918 91 P

Samarinda
RS Dirgahayu Samarinda Hospital & Clinic JL. Gunung Merbabu No.40 (0541) 742116 P P P
RS Haji Darjad Samarinda Hospital IPD Only Jl. Dahlia No. 4 (0541) 732 698 P P
RS Islam Samarinda Hospital & Clinic Jl. Gurame No. 18 (0541) 7415 10 P P P P P
RSUD A. Wahab Sjahranie Hospital & Clinic Jl. Palang Merah Indonesia (0541)738118 P P P P P

Sangatta
RS Prima Sangatta Hospital & Clinic Jl. Yos Sudarso I No. 1 (0549) 24555 P P
RS Sangatta Occupational Health Hospital & Clinic Jl. Yos Sudarso IV, No. 1 (0549) 23417 P P P P P
Centre
RSU Meloy Sangatta Hospital & Clinic Jl. Yos Sudarso II No. 101 (0549) 2026258 P P P P P

Tarakan
Pertamedika Hospital Tarakan Hospital & Clinic Jl. Mulawarman No. 14 (0551) 31403 P P P P P

State/Province: Kepulauan Riau

Batam
Klinik Umum & Gigi Casa Medical Clinic - Not 24 Hours Jl. Imam Bonjol Komp.Bumi Indah B/4, (0778) 458 813 P P
utama Nagoya
Klinik Umum Casa Astek Sekupang Clinic - Not 24 Hours Komp.Pertokoan Cipta Puri CC/3 Tiban (0778) 702 0317 P
Selatan
Klinik Umum Casa Batu Aji Clinic - Not 24 Hours Komp.Batu Aji Centre B/ 3 Batu Aji (0778) 702 0326 P
Klinik Umum Casa Medical Clinic - Not 24 Hours Komp. Taman Indah Sentosa Blok (0778) 371 002 P
Bengkong F/19, Sei Panas
Klinik Umum Casa Medical Jodoh Clinic - Not 24 Hours Jl. Duyung Batu Ampar (Rumah Susun (0778) 431 974 P
Jamsostek), Batam
RB&Klinik Budi Rosari Maternity Only Hospital Jl. Mahkota Simpang No. 1, Bengkong (0778) 427854 P P P P
Mahkota
RS Awal Bros Batam Hospital & Clinic Jl. Gajah Mada Kav. I (0778) 431 777 P P P P P P
RS Harapan Bunda Batam Hospital & Clinic JL. Seraya 1 (0778) 458 808 P P P P
RS Santa Elisabeth Batam Hospital & Clinic Jln. Anggrek Blok II (0778) 457357 P P P P P
RSU Casa Medical Centre Hospital & Clinic Jl. Jend. A. Yani No.8 Muka Kuning, (0778) 371 002 P P
Batam

State/Province: Lampung

Released: 12 May 2010, 1:53:56PM Page 17 of 21

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Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Lampung

RS Advent Bandar Lampung Hospital & Clinic Jl. Teuku Umar No. 48 (0721) 703 459 P P P P P
RS Bumi Waras Hospital & Clinic Jl. Wolter Mongonsidi No. 235, Teluk (0721) 254499 P P P
Betung
- Outpatient cashless services only available for GP and Emergency Room treatments
RS Immanuel Way Halim Hospital & Clinic Jl. Soekarno-Hatta, Tromol Pos I, (0721) 704 900 P P P
Bandar Lampung

State/Province: Maluku

Ambon
RSU Al Fatah Ambon Hospital & Clinic Jl. Sultan Babullah No. 2 (0911) 343428 P P P P P P

State/Province: Nanggroe Aceh Darussalam

Banda Aceh
RS Harapan Bunda Banda Aceh Hospital & Clinic Jl. Teuku Umar No. 181-223 (0651) 48114 P
RS Permata Hati Banda Aceh Hospital & Clinic Jl. Sultan Iskandar Muda No. 217 (0651) 742 8872 P P P P P
RS Teungku Fakinah Hospital & Clinic Jl. Jend.Sudirman 27-29 (0651) 41454 P
RSU Bulan Sabit Merah Indonesia Hospital & Clinic Jl. Sultan Malikul Saleh, Lamlagang (0651) 638701 P P P P P

Lhokseumawe
RS TK IV IM.07.01 Hospital & Clinic Jl. Samudra (0645) 40300 P
Lhokseumawe(RS TNI AD)
RSU Bunda Lhokseumawe Hospital & Clinic Jl. Darussalam No. 16, Aceh Utara (0645) 46924 P P
RSU Bunga Melati Hospital & Clinic Jln. Samudera Baru No. 3 Keude Aceh 0645 - 44821 P P
- Lhokseumawe
RSU Kasih Ibu Lhokseumawe Hospital & Clinic Jl. Merdeka No. 17 Simpang Blang (0645) 48713 P P P P P
RSU Sakinah Hospital & Clinic Jl. Antara No. 30 (0645) 45534 P P P

State/Province: Nusa Tenggara Barat

Lombok
Permata Hati Maternity Clinic Maternity & Children Jl. Majapahit No. 8 Mataram (0370) 631 999 P P P

Mataram
Klinik Lawang Gali Clinic - 24 Hours Jl. Sudirman No. 2, Sumbawa Besar (0371) 2709693 P P P P P
RS Biomedika Hospital & Clinic Jl. Bung Karno No 143 (0370) 645137 P P
RSB Exonero Maternity Only Hospital Jln. Pemuda No. 16 (0370) 636454 P P P

State/Province: Nusa Tenggara Timur

Ruteng
RS St. Rafael Cancar Hospital & Clinic Jl. Santurafael Cancar, (0385) 22944 P P P P
Manggarai,Ruteng

State/Province: Papua (Irian Jaya)

Timika
Klinik & RB Hadeli Sari Timika Hospital & Clinic Jl. Cendrawasih SP.II, TIMIKA (0901) 322541 P P P P
Klinik Dian Timika Clinic - 24 Hours Jl. Yos Sudarso No. 54 Timika 081354089988 P P

State/Province: Papua Barat

Sorong
Prima Medical Centre Clinic - 24 Hours Jl. Ahmad Yani No. 24 (0951) 333666 P P

Released: 12 May 2010, 1:53:56PM Page 18 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Riau

Duri
Klinik Dr. Agung Clinic - Not 24 Hours Jl. Jend. Sudirman No. 34, Mesjid 08127574025 P P
Jamil
Klinik Permata Hati II Clinic - 24 Hours Jl. Jend. Sudirman No.55, Simp. (0765) 91155 P
Padang
RS Permata Hati Duri Hospital & Clinic Jl. Jend. Sudirman No.37 Duri (0765) 598 101 P P P P
RS Thursina Duri Hospital & Clinic Jl. Jend. Sudirman No.65, Riau (0765) 5977 73 P P P P P

Pekanbaru
Eka Hospital Pekanbaru Hospital & Clinic Jl. Soekarno Hatta Km.6,5 (0761) 6989999 P P P P P P
RS Awal Bros Pekanbaru Hospital & Clinic Jl. Jend. Sudirman no.117 (0761) 47333 P P P P P P
RS Santa Maria Pekanbaru Hospital & Clinic Jl. Jend. Ahmad Yani No.68, (0761) 222 13 P P P P P
Pekanbaru
RS. Pekanbaru Medical Centre Hospital & Clinic Jl. Lembaga Pemasyarakatan, (0761) 848 100 P P P P P
Pekanbaru
RSB Budhi Mulya Maternity Only Hospital Jl. Sisingamangaraja No. 25 (0761) 22815 P P P P P
RSI Ibnu Sina Pekanbaru Hospital & Clinic Jl. Melati No. 60, Pekanbaru (0761) 24242 P P P P P

State/Province: Sulawesi Barat

Polewali
RSUD Polewali Hospital & Clinic Jl. Dr. Ratulangi No. 50 (0428) 21451 P P P P P

State/Province: Sulawesi Selatan

Makassar
RS Bhayangkara Andi Mappa Hospital & Clinic Jl. letjen Pol. Andi Mappa Oudang No. (0411) 872 514 P P
Oudang 63, Makassar
RS Dr. Wahidin Sudirohusodo Hospital & Clinic Jl. Perintis Kemerdekaan Km.11, (0411) 584675/7 P P P
Tamalanrea
RS Islam Faisal Hospital & Clinic JL. A. Pangerang Pettarani (0411) 871 942 P P
RS Labuang Baji Hospital & Clinic Jl. Ratulangi No. 81, Somba Opu (0411) 872 120 P P
RS Stella Maris Hospital & Clinic JL. Somba Opu No. 273 (0411) 871 391 P P P P P
RS TK. II Pelamonia Hospital & Clinic Jl. Jend. Sudirman No. 27, Makassar (0411) 324 710 P P

Pare-pare
RS Fatima Pare-pare Hospital & Clinic Jl. Ilham 3 (0421) 21847 P P P P P

State/Province: Sulawesi Tengah

Luwuk
RSB Irene Maternity Only Hospital Jl. RA Kartini No. 25 (0461) 21202 P P P
RSUD Luwuk Hospital & Clinic Jl. Imam Bonjol KM. 3 (0461) 21820 P P P P P

Palu
RS "Woodward" Palu Hospital & Clinic Jl. L.H. Woodward no.1 (0451) 421 769 P P P

State/Province: Sulawesi Utara

Bitung
RSAL BITUNG Hospital & Clinic Jl. Yos Sudarso No. 26, Bitung (0438) 21264 P P
RSUD Bitung Hospital & Clinic Jl. Manembo-nembo, Bitung (0438) 38066 P P

Manado
RS Advent Manado Hospital & Clinic Jl. 14 Februari No. 1 Teling Atas (0431) 847950 P P P P P P
RS Pancaran Kasih Hospital & Clinic Jl. Sam Ratulangi XIII, Manado (0431) 865 800 P P
RSI Sitti Maryam Hospital & Clinic Jl. Pegiden Raya no. 53, Tuminting (0431) 851 577 P P
RSU Prof.dr.R.D.Kandou Manado Hospital & Clinic Jl. Raya Tanawangko (0431) 838203 P P P

Released: 12 May 2010, 1:53:56PM Page 19 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Sumatera Barat

Bukit Tinggi
RSI Ibnu Sina Bukit Tinggi Hospital & Clinic Jl. Batang Agam (0752) 21208 P P P P P

Padang
RS Khusus Bedah Ropanasuri Hospital & Clinic Jl. Aur No. 8 0751-31938 P P
Padang
RS Selaguri Padang Hospital & Clinic Jl. Jend. Ahmad Yani No. 26, Padang (0751) 33010 P P P P P
RS Yos Sudarso Hospital & Clinic Jl. Situjuh No.1 (0751) 33230 P P P
RSI Ibnu Sina Padang Hospital & Clinic Jl. Gajah Mada, Gunung Pangilun (0751) 444712 P P P P P
RSI Siti Rahmah Padang Hospital & Clinic Jl. Raya By Pass KM 15 (0751) 463059 P P P P P
RSU C-BMC Padang Hospital & Clinic Jl. Proklamasi no. 37, Padang (0751) 23164 P P P P P

State/Province: Sumatera Selatan

Palembang
RS Islam Siti Khadijah Palembang Hospital & Clinic Jl. Demang Lebar Daun, Pakjo (0711) 356 008 P P P P
RS R.K. Charitas Palembang Hospital & Clinic Jl. Jend. Sudirman No.1054 (0711) 350 426 P P P P

Prabumulih
RS AR Bunda Prabumulih Hospital & Clinic Jl. Angkatan 45 (0713) 322 954 P P P P
RS Pertamina Prabumulih Hospital & Clinic Jl. Kesehatan No.100, Komperta (0713) 382 742 P P P P

State/Province: Sumatera Utara

Binjai
RSU Artha Medika Binjai Hospital & Clinic Jl. Samanhudi No. 22 (061) 8827277 P P P P P

Medan
Gleni International Hospital Hospital & Clinic Jl. Listrik No. 6 (061) 456 6368 P P P P P P
- We have received patient complaints re this hospital. The hospital tells us it occurs because some of their doctors demand cash payment. They
tell us they cannot control this. If you want to avoid possible problems consider using another facility.
Klinik Spesialis Bunda Medan Clinic - Not 24 Hours Jl. Sisingamangaraja No.17 (061) 732 1666 P P
Medan Medical Center Clinic - Not 24 Hours Jln. Haji Agus Salim (061) 4535 522 P
RS Advent Medan Hospital & Clinic Jl. Gatot Subroto KM. 4, Medan - Binjai (061) 452 4875 P P P P P P
RS Haji Medan Hospital & Clinic Jl. RS Haji Medan Estate (061) 661 9520 P P
RS Horas Insani Hospital & Clinic Jl. Medan Km. 2,5, Pematang Siantar (0622) 433 444 P P
RS Islam Malahayati Hospital & Clinic Jl. Diponegoro No. 2 (061) 4518766 P P P P P
RS Methodist Medan Hospital & Clinic Jl. MH. Thamrin Medan 105 (061) 736 9000 P P P P P
RS Permata Bunda Medan Hospital IPD Only Jl.Sisingamangaraja No 7 (061) 736 2777 P P
RS Santa Elisabeth Medan Hospital & Clinic Jl. H. Misbah No. 7 (061) 414 4737 P P
RS Sari Mutiara Hospital & Clinic Jl. Kapten Muslim No.79 (061) 845 1812 P P P P P
RSU Dewi Maya Hospital & Clinic Jl. Surakarta No. 2 (061) 455 1333 P P P P P
RSU Materna Medan Hospital & Clinic Jl. Teuku Umar No. 9 - 11 (061) 451 4222 P P
RSU Sarah Medan Hospital & Clinic Jl. Baja Raya No. 10 (061) 452 8744 P P P P P

Padang Sidempuan
RSU Ester Kabanjahe Hospital & Clinic Jl. Veteran No. 21, Kabanjahe, Kab. (0628)20714 P P P P
Karo

State/Province: Yogyakarta

Released: 12 May 2010, 1:53:56PM Page 20 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net
Facility Name Type Address Telephone IP M O DB DC Opt M

State/Province: Yogyakarta

BP&RB PKU Muhammadiyah Hospital & Clinic Jl. KHA. Dahlan No. 11, Wates, Kulon (0274) 773430 P P P P
Wates Progo
Jogja International Hospital Hospital & Clinic Jl. Ring Road Utara No. 160 (0274) 4463535 P P P P P P
Klinik Diagnostik " CITO " Bantul Clinic - Not 24 Hours Jl. Raya Bantul km.10, Melikan Lor (0274) 7101015 P
Bantul
RS Bethesda Hospital & Clinic Jl. Jendral Sudirman, No. 70 (0274) 586 688 P P P P P
RS Happy Land Medical Centre Hospital & Clinic Jl. Ipda Tut Harsono No. 53, Timoho (0274) 550060 P P P P P
RS Ludira Husada Tama Hospital & Clinic Jl. Wiratama No.4, Tegalrejo (0274) 620 333 P P P P P
RS Panti Nugroho Hospital & Clinic Jl. Kaliurang Km. 17, Pakem (0274) 895 186 P P
RS Panti Rini Hospital & Clinic Jl. Solo Km. 12,5, Kalasan (0274) 496 022 P P P
RS PKU Muhammadiyah Hospital & Clinic Jl. KH Ahmad Dahlan No. 20 (0274) 512 653 P P P
Yogyakarta
RS. St. Elizabeth Bantul Hospital & Clinic Jl. Ganjuran, Sumber Mulya, Bantul (0274) 367 502 P P
RSUD Wates Hospital & Clinic Jl. Tentara Pelajar KM. 1 No. 5, Wates (0274) 773169 P P P P P
- Kulonprogo
Klinik Diagnostik "CITO" Yogyakarta Clinic - Not 24 Hours Jl. Atmosukarto 4 (0274) 563 656 P

If you would like a Healthcare Provider added to our Network, please fax us at (021) 782 9332 or email our team at
Provider.Services@Global-Assistance.net.

We are always happy to add quality healthcare providers to our Network, especially where we do not have alternate providers available.

Experiencing a Problem? If you or your employees experience any problems in accessing services at any one of the Healthcare Providers
included in our List, call your Customer Service Hotline immediately. The number is on the back of your Membership Card. If you call us
while you are still at the hospital or clinic - we most likely can help you immediately.

You can also email us at Provider.Services@Global-Assistance.net and we will investigate any concern you might have with one of our
Network Providers. Remember, to help us in our discussions with the Healthcare Provider, we need to know the date, time, location and
name of the Provider Staff who created the problem. Perhaps it is a new Receptionist at the Provider's Admissions Desk that needs training -
the only way we can work together with our contracted Providers to ensure you are provided the best service, is to have as many details as
we can from you about any problem you have in accessing service from our Network Providers. Don't forget to let us know about any
concerns you might have with medical practices or treatments also.

For udpates to our Provider List or for information on our other services, please check our website www.Global-Assistance.net or check with
your HR Department.

Released: 12 May 2010, 1:53:56PM Page 21 of 21

Network Listing - Indonesia Only All Services
Maximizing Service, Minimizing Risk
Health Benefits Administration & Risk Management
PT Global Asistensi Manajemen Indonesia (GAMI)
Graha Simatupang Tower 1D 8th Floor, Jl. Letjend. T.B. Simatupang Kav 38, Jakarta 12540, Indonesia
Telephone +62 21 782 8040 Fax: +62 21 782 9332 Email Customer.Service@Global-Assistance.net