FOR PRACTICES, CLINICS & FACILITIES · REFERRAL LINE [PHONE NUMBER] · SECURE FAX [FAX NUMBER]PATIENTS: [PHONE NUMBER]
MeridianSpecialty & LTC PharmacySend a referral
SEND A REFERRAL

Send it to us. That’s your office’s whole job.

A / E-PRESCRIBENCPDP [NUMBER]Search “Meridian Pharmacy” in your EHR. NPI [NPI NUMBER].
B / SECURE FAX[FAX NUMBER]Use your own form, or ours: [REFERRAL FORM LINK].
C / CALL[PHONE NUMBER]Talk it through with the coordinator who’ll own it.

Helpful but not required: the last progress note and a copy of the insurance card. If the plan needs more, we’ll ask once, specifically.

NEW TO MERIDIAN?

Set up your practice in five minutes.

Tell us how your office works. A family member will call within [TIMEFRAME] to introduce your coordinator — and to offer an in-person visit.

We’ll bring lunch. — [Name]
What kind of setting? (choose any)
Do your clinicians administer medications in-office?
How should we keep you updated? (choose any)

This form is for practice setup only. Please send prescriptions and patient information by e-Rx or secure fax.

PRACTICE LIAISON[NAME]Direct [PHONE NUMBER]
[EMAIL]
THE PHARMACY[STREET ADDRESS]
[CITY, STATE ZIP]Mon–Fri [HOURS] · Sat [HOURS]
ARE YOU A PATIENT?If your provider sent your prescription to us, you don’t need to do anything — we’ll call you. Questions in the meantime: [PHONE NUMBER].