PHARMACY DOCUMENTS
E-PRESCRIBE FOR YOUR PATIENTS OR ORDER BY FAX, PHONE OR MAIL
Ordering Prescriptions
There are four ways to order initial or refill prescriptions from our pharmacy. Find your preferred method of contact in the chart below, as well as quick links to Specialty prescription and enrollment forms.
E-PRESCRIBE
NCPDP 36-79252
FAX (for prescribers only)
1-877-309-0687
PHONE
1-877-437-9012
MAIL
7835 Freedom Ave NW, North Canton, OH 44720
Condition-Specific Prescriber Forms
- Specialty Pharmacy Prescription and Enrollment Form
- Crohn's Disease Prescription and Enrollment Form
- Growth Disorder Prescription and Enrollment Form
- Hematopoietic / GCSF Prescription and Enrollment Form
- Hemophilia Prescription and Enrollment Form
- Hepatitis C Prescription and Enrollment Form
- Immune Globulin Prescription and Enrollment Form
- Long Acting Psychotopic Prescription and Enrollment Form
- Multiple Sclerosis Prescription and Enrollment Form
- Oral Oncology Prescription and Enrollment Form
- Osteoporosis Prescription and Enrollment Form
- Psoriatic Arthritis Prescription and Enrollment Form
- Psoriasis Prescription and Enrollment Form
- Rheumatology Prescription and Enrollment Form
- Synagis Prescription and Enrollment Form
- Ulcerative Colitis Prescription and Enrollment Form
