Either the pharmacy name or pharmacy number must be submitted with the form.
Please make sure that one of these required fields contains information. Thank you.
You can count on your local independent Pharmacy to provide a level of service not available from large chain stores. We provide the service you need when you need it at a competitive price. And we understand and care about your health.
Choose a Pharmacy
You may order refills for any prescription currently on file at your participating local Pharmacy. It's quick and easy; you just need the name of your pharmacy and your prescription numbers. Order refills any time of the day or night, from work or home.