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Sign Up Today

And Save on Over 10,000 Products

Sign Up with the Secondary Distributor that’s Second to None

Fill out the registration form below and a dedicated account manager will contact you shortly to complete your application.

Are you a current Masters customer and need assistance?

Please enable JavaScript in your browser to complete this form.

Name *

Business Name *

Email *

Phone Number *

Address *

City *

State *

Zip Code *

What type of business are you?

Retail Pharmacy
Dr./Physician Office
Clinic
Hospital
LTC Facility
Wholesaler
Other for OTC Only

Who is your primary vendor?

AmerisourceBergen
Cardinal
McKesson
Other

What products are you focused on?

Brands
Generics
OTCs
Topicals
Diabetic Supplies
Other

Select all that apply

How did you hear about Masters?

Search Engine
Online Ad
Linkedin
Phone Call
Word of Mouth
Tradeshow
RxInsider
Other

Have you spoken to a Masters Sales Rep? If so, what was their name?

(Optional)

Do you hold any State or Federal Licenses? *

A valid license is required to order from Masters Pharmaceutical.

If you are a new pharmacy awaiting licensing, please submit the form to speak to a representative about your situation.

Please select all that apply:

DEA#
STATE#
GLN# (What is a GLN?)

DEA#

DEA#

Format: AA-9999999 (dash optional)

DEA # - Providing at later date

I will provide at a later date

State#

State#

Format: Alphanumeric (First 5 required then up to 18 characters)

State # - Providing at later date

I will provide at a later date

Ship-to address GLN#

Ship-to GLN#

Format: Numeric (First 12 required then up to 13 numbers)

Sold-to Address GLN#

Sold-to GLN#

Format: Numeric (First 12 required then up to 13 numbers)

GLN# Ship-to and Sold-to

GLN# - Providing at later date

I will provide at a later date

Additional Info

Message

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DSCSA Information

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3600 Pharma Way, Mason, Ohio 45036
info@MastersRx.com
800.982.7922
800.201.6610

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