License Information

State Pharmacy/Medical License Number * {{generalValidationMsg}} Pharmacy/Medical License Number should not contain more than 50 characters

{{deaLabel}} * {{generalValidationMsg}} DEA License Number should not contain more than 50 characters

Sales Tax-Exempt Cert Number {{ taxExemptNumValidateMsg }}

NPI Number * {{ npiNumValidationMsg }} NPI Number should not contain more than 50 characters

State Lic Expiration Date *

{{deaExpiresLabel}} *

Sales Tax-Exempt Cert Expires

Federal Tax ID * {{generalValidationMsg}} Federal Tax ID should not contain more than 100 characters

340B Status

Primary GPO / Buying Group * {{selectBoxValidationMsg}}

If Other, please specify {{ generalValidationMsg }} {{storeInfo.getValidationMsg('gpo_primary_buying_group_name')}}

Secondary GPO / Buying Group {{selectBoxValidationMsg}}

If Other, please specify {{ generalValidationMsg }} {{storeInfo.getValidationMsg('gpo_secondary_buying_group_name')}}

Global Location Number (GLN)* {{generalValidationMsg}} Global Location Number (GLN) should not contain more than 50 characters

Your 13-digit Ship to GLN identifies your location as required by DSCSA. If you don’t know it, check an invoice from your Primary Wholesaler, or click the link to search for it here: Global Location Number Lookup
To get a GLN, visit this link: GS1 website