Select a program option below to begin the process.
Once completed, a customer service representative will be in contact with your pharmacy. For questions during enrollment, you may contact us at the toll free number (888) 255-6526 (8:30am-5:30pm CST M-F).
Click here to continue an enrollment you already started.
Completed and signed documents can be returned here:
P.O. Box 12428
Overland Park, KS 66282