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Morphinans / Drug rehabilitation / Ethers / Ketones / Buprenorphine / Opioid dependence / Methadone / Naloxone / Medical prescription / Chemistry / Organic chemistry / Alcohols


State of Maine Department of Human Services
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Document Date: 2012-05-01 10:46:27

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File Size: 305,01 KB

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Company

Goold Health Systems / Pharmacy Prescription Drug Monitoring Program / /

Facility

Pharmacy NPI / University of Washington / GHS pharmacy / Pharmacy Services Program PRIOR AUTHORIZATION REQUEST FORM / Pharmacy Name / /

Organization

University of Washington / Department of Health Division of Healthcare Financing Dear Providers / /

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Position

Major / General / Case Manager / /

Product

SUBUTEX / SEROQUEL / naloxone / SUBOXONE / /

ProvinceOrState

Wyoming / /

URL

www.wyequalitycare.org / http /

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