Create a Pharmacy Account

* Indicates a required field.

Basic Account

Complete the following information for access to basic online pharmacy services.

Create Username and Password

Your Information

Account Preferences - Optional

AutoFill

AutoFill will automatically refill each enrolled prescription when they are available to be filled. Click the check box below to request AutoFill enrollment on all future refills.
Please be aware that some medications are not eligible for AutoFill.

Prescription Information - Optional

For access to your prescription profile and point-and-click "Whenever Wherever" refill service, provide your Birthdate, specify a recent prescription number, and select the pharmacy where the prescription was filled. For security purposes, this information must exactly match the information in the pharmacy records.

Account Information


Prescription bottle label example, see bottle supplied by pharmacy

Select the Pharmacy where Prescription was filled

or

or


Upon successful registration for your online prescription profile, you will be issued a confidential PIN that is required to activate your online Rx Profile. Your PIN will be emailed to the address you specified above in your account registration. To ensure that your mail server will accept this email, please add the following email address to your Approved Senders list: webmaster@nhin.com