Provider Index > Supervising Pharmacist
Provider Enrollment & Maintenance
Enrollment required when employed by a freestanding pharmacy.
Complete this Enrollment Form if you are:
- Applying for initial ENROLLMENT or ALREADY ENROLLED and enrolling another NPI, or
- Responding to a letter instructing you to REVALIDATE your enrollment, or
- Seeking REINSTATEMENT or REACTIVATION of your previous enrollment
PRACTITIONER Enrollment Form