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Call in with your information, OR fax or e-mail in the downloadable New Customer Form (52 KB), which you can also use for reference when calling in.
If calling in an order for the first time, have the following patient information on hand:
- name
- address
- phone#
- date of birth
- social security#
- list of allergies
- insurance info (all found on insurance card)
- insurance company
- ID/Member#
- Group#
- PCN# or BIN#
- credit card#, exp. date, CVV2 code, billing zip
- pick-up/shipping/delivery info
Also, send us a copy of your written prescription via fax or e-mail so we can verify it with
your doctor and start filling your order. Then mail us the original within 7 days for our files. If you do not
have a written prescription yet, call your doctor and have him/her call or fax in the prescription for you.
Follow the process for new customers above. In addition to the information above, we will also need:
- name of previous pharmacy
- prescription# of drug at previous pharmacy
- phone# of previous pharmacy
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Please send us a copy of your written prescription via fax or e-mail so we can verify it with
your doctor and start filling your order. Then mail us the original within 7 days for our files. If you do not
have a written prescription yet, call your doctor and have him/her call or fax in the prescription for you.
In addition, you must call the pharmacy, OR fax or e-mail us a Fill New Prescription Form (52 KB) so we can process your prescription and designate pick-up, mail, or local delivery.
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You can fax or e-mail us a Refill Prescription Form (52 KB), or call in the 8-digit prescription# located on the top left of your medication's container, along with pick-up, shipping, or delivery information. If you do not have a container, we need your name, phone#, and name of the item requested.
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