Wholesale Distributor License Application. When there is a name change of the pharmacy or a change in the pharmacist who is licensed by the state of Maryland as per the requirement for a Non-Resident Pharmacy Permit, a fee or inspection is not required. Outsourcing Facility Permit Application. Non-Resident Louisiana Pharmacy Permit (for non-resident pharmacies only) 052 ~ Application for New Non-Resident Pharmacy Permit (Revised 01-01-2019) 057 ~ Application for Renewal of Nonresident Pharmacy Permit for Year 2021 ... 061 ~ Notification of Change of Pharmacist … When to Apply. Nonresident Pharmacy: as defined in regulation part 6.24. C. §2535).Non-Resident Pharmacies must comply with Title 24, Chapter 25 of the Delaware Code when dispensing for Delaware clients. Request for Increase in Technician-to-Pharmacist Ratio. Name/address changes: Pharmacists may change their address, home phone number, email address, and name online through the Gateway. The Non-Resident Non-Dispensing Pharmacy permit is the only permit that requires the Pharmacist-In-Charge to be a South Carolina licensed Pharmacist. Address Correction (this includes change of street name or number made by the United States Postal Service, government entity, suite number, etc) Does NOT include a change of location. This includes a sterile compounding pharmacy attached to a license. NON-RESIDENT PHARMACIES - E-mail: firstname.lastname@example.org: New Non-Resident Pharmacy Application : 797 Sterile Compounding Questionnaire (Must also submit VPP Inspection) 795 Non-Sterile Compounding Questionnaire (Must also submit VPP Inspection) Change of Name or Address Form : Reinstatement/Change of Ownership Form Warehouser Application. The Colorado State Board of Pharmacy regulates pharmacists, pharmacy interns, in-state and nonresident pharmacies, in-state and out-of-state prescription drug wholesalers, satellite pharmacies, specialized prescription drug outlets, other outlets, and limited licenses. Welcome to the Pharmacy Homepage. Clinical Pharmacist Practitioner Forms and Information. A Nonresident Pharmacy is a pharmacy located outside New Mexico that ships, mails, or delivers in any manner prescription drugs to New Mexico patients or consumers. www.pharmacy.texas.gov and select the “Verification” tab. A pharmacy located outside Delaware must hold a Delaware Non-Resident Pharmacy permit in order to ship, mail, or deliver, in any manner, any controlled substance or prescription drug to a patient in Delaware (24 Del. Pharmacist-Manager Responsibilities. However, legal documentation of the name change or pharmacist change must be submitted. A policy and procedure manual is required with the initial application. A separate Change of Permit application and fee must be submitted for each separate license. Non-Restricted Manufacturer Permit Application. The DRIC serves as supervisor or manager and is responsible for ensuring the wholesaler’s or veterinary food-animal drug retailer’s compliance with all the state and federal laws and regulations pertaining to practice and the applicable license. Application for Re-Inspection of a Facility . All applications submitted to the Board have a one year expiration date before the applications are withdrawn. If you have any issues with the email or fax line contact TSBP at (512) 305-8047 **Non-Resident Pharmacist-in-Charge must have a Texas Pharmacist License , see Forms for Facilities (Out-of-State) Non-Resident Pharmacy Registration Application Third-Party Logistics Provider Permit Application. Please contact the Board for more information.