Pharmacy signup · SiCentralFill

Step 1 of 4 · Pharmacy details

1 of 4

01 Pharmacy details

Legal name *

Enter the legal name of the pharmacy.

NPI *

10-digit identifier.

Enter a 10-digit NPI.

NCPDP *

7-digit pharmacy identifier.

Enter a 7-digit NCPDP ID.

DEA (optional)

2-character prefix followed by 7 digits.

Enter a letter, another letter or 9, and seven digits.

Central Fill participation *

Select one or both options.

Request medications from Central Fill (Dispensing / Requester)

Select at least one Central Fill option.

Prepare and send medications to the requesting pharmacy (Central Fill)

Select at least one Central Fill option.

Pharmacy address

Address *

Enter the address.

Unit, suite or building (optional)

ZIP code *

Enter 5 digits to fill in the city and state.

Enter a 5-digit ZIP code.

City *

Enter the city.

State / territory *

Select the state or territory.

02 Licenses

Add your pharmacy’s state licenses.

State / territory *

Select the state or territory.

License number *

Enter the license number.

03 Contacts

Add the primary contact for your pharmacy.

First name *

Enter the contact’s first name.

Last name *

Enter the contact’s last name.

Role (optional)

Email address *

Enter a valid email address.

Phone *

Enter a 10-digit phone number.

Register your pharmacy

Central Fill participation *

Pharmacy address