Board Notice - Louisiana Board of Pharmacy 2025

1. Click ‘Get Form’ to open the application for the Louisiana Hospital Off-Site Satellite Pharmacy Permit in our editor.
2. Begin with Section 1, where you will select the type of permit requested. Choose 'PHY-SAT' for Hospital Off-Site Satellite and note the $175 fee.
3. In Section 2, indicate whether this is a new pharmacy permit or a change of ownership. Fill in the anticipated date of opening.
4. Proceed to Section 3 to provide details about the provider pharmacy, including its name, address, and LDH License number. Ensure you attach a legible copy of the license.
5. Complete Section 4 by entering information for the designated contact person, including their name, company, and contact details.
6. In Section 5, include a corporate resolution that authorizes the Pharmacist-in-Charge to execute this application.
7. Fill out Sections 6 through 10 with relevant information regarding satellite pharmacy details, special services offered, required attachments, controlled substances licensing, and attestations.
8. Review your completed application thoroughly before submission to avoid delays due to incomplete documents.

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