Gather the information needed
The following information is required for submitting a compounded prescription:
- Patient Information – First Name, Last Name, Date of Birth, Gender, Address, Cell Phone Number, Email, Known Drug Allergies, and Patient Identifier (in applicable states).
- Prescription Information – Date, Drug(s), Dose, Dosage Form, Directions indicating the frequency of use and the route of administration, Quantity, and Refills.
- Prescriber Information – First Name, Last Name, Practice Address, Phone Number, Fax Number, NPI #, State License Number, DEA License, and State Controlled Substance Registration (where applicable).
- Prescriber Signature – Provide an authentic pen-to-paper prescriber signature for all controlled substances. Stamped and faxed electronic signatures are not considered valid by the DEA. Submitting controlled substances via EPCS-certified software is preferable.
- Payment Type – If your patient is paying the pharmacy directly, please follow the instructions below to send in a prescription. If you wish to be billed, please open an account.
Send in your prescription
We offer multiple convenient ways to submit a patient prescription:
Call the toll-free phone number that corresponds with the Belmar Pharmacy location where you wish to submit a prescription:
- Colorado: 800-525-9473 (Select 3 to speak with a pharmacist or leave a voicemail.)
- Arizona: 800-699-8143
- Wisconsin: 800-279-5708
- Florida: 877-418-4692
- Kansas: 316-721-2626
- Utah: MedQuest Pharmacy 888-222-2956
Fax to the toll-free number that corresponds with the Belmar Pharmacy location where you wish to submit a prescription:
- Colorado: 866-415-2923
- Arizona: 800-330-0268
- Wisconsin: 800-279-8011
- Florida: 877-418-4690
- Kansas: 303-729-0047
- Utah: MedQuest Pharmacy 866-373-2979
If there is any missing information, we will contact you via fax.
To submit prescriptions through your EMR, search for us using our NCPDP number (see below), or simply search Belmar Pharmacy by location: Colorado, Arizona, Wisconsin, Florida, Kansas, and our connection information should populate.
- Colorado: 0604923
- Arizona: 322773
- Wisconsin: 5117773
- Florida: 5756065
- Kansas: 1717935
- Utah: MedQuest Pharmacy 4608608
Our free, secure Prescriber Portal enables you to view, track, and write prescriptions online. The portal offers:
- User-friendly prescribing tools for quick, easy ordering
- Real-time order status
- Easy refill entry
- Access to patient order delivery tracking
- Personalized medication lists customizable to your practice
To set up access to our Prescriber Portal, please contact us.
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