Prompt | Response | Req | Len |
---|---|---|---|
Pharmacy Code | Type the code you want to edit or create or click the magnifying glass to search the table. This code cannot begin with a zero. | 5 | |
Pharmacy Name | Type the pharmacy name. | 45 | |
Address Line One | Type the pharmacy's address. | 40 | |
Address Line Two | Type any additional address information. | 40 | |
City, State | Type the city and state. It should be entered in the exact format shown. For example, Phoenix, AZ. Type the city name - then a comma - then one space - and the two letter state code. | 30 | |
Zip Code | Type the zip code. | 10 | |
Contact Individual | Type the individual to contact at this pharmacy. | 30 | |
Telephone Number | Type the phone number for this pharmacy. | 15 | |
Fax Number | Type the fax number for this pharmacy. | 15 | |
Comment | Type any neccesary comment text. | 40 | |
Comment | Type any neccesary comment text. | 40 |