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How to use or fill out Base Datos PDF Word Press Internet with our platform
- Click ‘Get Form’ to open the Base Datos PDF in the editor.
- Begin with Section 1, selecting the type of permit requested. Check the box for 'Hospital Off-Site Satellite' and ensure you include the $175 fee.
- In Section 2, indicate whether this is a new pharmacy permit or a change of ownership. Fill in the anticipated date of opening if applicable.
- Proceed to Section 3, where you will enter details about the provider pharmacy. Include the name, physical address, and pharmacy permit number.
- Complete Section 4 by providing information for the designated contact person, including their name, company, and contact details.
- In Section 5, ensure that a corporate resolution is attached if applicable. This authorizes the Pharmacist-in-Charge to execute this application.
- Fill out Sections 6 through 10 as required, ensuring all necessary attachments are included before submission.
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