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Money / Medical prescription / Credit card / Payment / American Express / Cheque / Payment systems / Business / Economics


DRAFT New Prescription Order Form Mail this form to: PrimeMail® PO Box 27836
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Document Date: 2014-10-01 01:42:15

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File Size: 203,61 KB

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City

Albuquerque / /

Company

MasterCard / American Express / Prime Therapeutics LLC / /

Currency

USD / /

IndustryTerm

appropriate product / /

Organization

FDA / /

/

Position

Physician / /

Product

Asthma Depression Heart condition Hypertension Other Other PATIENT’S NEW PRESCRIPTIONS / Fora prescriptions / PrimeMail / Erythromycin / Penicillin / Forrequire prescriptions / /

ProvinceOrState

New Mexico / /

URL

www.MyPrime.com / /

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