New Account Application

Fax: 718-301-1227 / 646-292-5120

P.O. BOX 230122

BROOKLYN , NY 11223

New AccountUpdate Existing Account

To ensure no delays in orders Submit a copy of Your RESALE CERTIFICATE Attach Your Latest Financial Statements if requesting Credit ( FAX TO CREDIT DEPT 718-301-1227 )

Corporate Info

CorporationPartnershipLLCOTHER
PharmacyReligious OnRetailWholesalerBroker

Bank References

CHECKINGSAVINGSLINE OF CREDITOTHERAccount#

Business/trade references

WE WILL NOT PROCESS IF YOU DO NOT ATTACH YOUR RESALE CERTIFICATE

Cart Item Removed. Undo
  • No products in the cart.