Pharmacy Telephone Number Sample Clauses

Pharmacy Telephone Number. A) Number of clients receiving Methadone supervised consumption for at least 14 days in the month being claimed for @ £43.20/month
Sample 1Sample 2
AutoNDA by SimpleDocs
Pharmacy Telephone Number. Community Pharmacy Needle Exchange (CPNx) ~ Monthly Invoice Month claimed for ………………………………. Year:………………………….. Total Claim: Retainer fee (1/12 of £150.00) £12.50 = £12.50 Total Number of Exchanges ……….... x £1.58 = These fees are fully inclusive of VAT Total £ I certify that I have provided needle Exchange services for the number of times stated above and that this can be confirmed by entries in my monitoring forms. Signed …………………………………… Date…………………………………….. Name (print)………………………………Designation…………………………….. Please complete and return this form to: CPNx Service Commissioner Stockton Drug action Team, Tithebarn House, High Newham Court, Hardwick Xxxxxxxx on Tees TS19. FOR DAT/PCT use only Claim checked by ………………………………………………………………. Claim authorised by…………………………………………...Date……………… Stockton-on-Tees Teaching Primary Care Trust Appendix 2(B) Pharmaceutical services to Drug users Community Pharmacy Needle Exchange (CPNx) ~ Claim for setting up costs Pharmacy Name: Pharmacy Stamp Pharmacy Address: Pharmacy Telephone Number: Accreditation requirements Date Signature Designated Lead completed CPPE training ( copy of certificate submitted) Standard operating procedure in place ( copy submitted as evidence) Training provided by service co-ordinator (High Street Project) Premises approved by service co-ordinator (High Street Project) Total Claim: Setting up fee for the provision of Community Pharmacy Needle Exchange(CPNx) = £500.00 I certify that the community pharmacy named above meets the accreditation requirements for the provision of community pharmacy needle exchange services (CPNx). Signed …………………………………… Date………………………………. Name (print)…………………………………Designation…………………….…. Please complete and return this form to: CPNx Service Commissioner Stockton Drug action Team, Tithebarn House, High Newham Court, Xxxxxxxx Xxxxxxxx on Tees XX00 0XX. FOR DAT/PCT use only Claim checked by ………………………………………………………………. Claim authorised by…………………………………………...Date……………… Stockton-on-Tees Teaching Primary Care Trust Appendix 3 Pharmaceutical services to Drug users Transaction form Records of transactions to be submitted to service co-coordinator by fax by the 5th of the month for the service provided in the previous month. A copy of the transactions to be sent to the service commissioner (Stockton DAT) with the monthly invoice. Details to be provided by CPNx Pharmacy coordinator Appendix 3A Pharmaceutical services to Drug users Exchange request form Details to be provided by CPxPharmcy co-ordina...
Sample 1
Pharmacy Telephone Number. Total Claim: Start up fee On behalf of the above pharmacy contractor, I certify agreement to provide ‘Healthy Heart Check’ services according to the Service Level Agreement. Signed …………………………………… Date………………………………. Name (print)……………………………………. Job Title………………………………………….. Pharmacy stamp Payment arrangements (eg Cheques payable to) Please complete and return this form return by post or fax to: Xxxxx Xxxxxxx, Public Health Portfolio Manager, NHS Stockton, Xxxxx Xxxxx, Xxxxxxxx Xxxxx, Xxxxxxxx xx Xxxx XX00 0XX Fax No: 00000 000000 Community Pharmacy CVD Screening Enhanced Service Version 4a – Phase 1 2009 44 Appendix 11 Hartlepool Middlesbrough Stockton on Tees Redcar and Cleveland Monthly Claim Form for Health Heart Check Please complete and return before the 7th of the month to: Contractor Claims Section Xxxxx Xxxxx Xxxxxxxxx Xxxx Xxxxxxxxx XX0 0XX Name and location of Pharmacy Pharmacy Code (if provided) Vat No. Month and Year
Sample 1
Pharmacy Telephone Number. Community Pharmacy Pregnancy Testing and Support Service (PTS) ~ Monthly Invoice Month claimed for ………………………………. Year:………………………….. Total claim Quantity Fee Total Monthly Retainer fee £ (fully inclusive of VAT) £12.50 (inc VAT) Total number of pregnancy test and support sessions ( fully inclusive of VAT) @ £11.75 (inc VAT) Total costs for month Please complete and return this form to: Sexual Health co-ordinator, NTPCT Public Health Department .Newtown Resource Centre Durham road Stockton on Tees North Tees Primary Care Trust FOR PCT USE ONLY: Claim checked and authorised by Signature Name Date North Tees Primary Care Trust Appendix F: Contact details (to follow)
Sample 1

Related to Pharmacy Telephone Number

  • Vendor Telephone Number Self explanatory. (Agency specific) 1d. Vendor E-mail Address - Self explanatory. (Agency specific) 2a. Course Title - Insert the title of the course or the program that the employee is scheduled to complete.

  • Home Telephone Number Employee's area code, home telephone number.

  • Office Telephone Number Insert the employee's area code, office telephone number and extension.

  • Toll-Free Telephone Number A contractor located outside of San Francisco is encouraged to provide free telephone services for placing orders. This requirement can be met by providing a toll-free telephone number or accepting collect calls. The free service will be a consideration in evaluating this bid.

  • Telephone Number Consumer Credit Associates, Inc. Call (000) 000-0000, either extension 000 Xxxxxxxxxxxx Xxxxxx, Xxxxx 000 150, 101, or 112, for all inquiries. Xxxxxxx, Xxxxx 00000-0000 Equifax Members that have an account number may call their local sales representative for all inquiries; lenders that need to set up an account should call (000) 000-0000 and select the customer assistance option. TRW Information Systems & Services Call (000) 000-0000 for all inquiries, 000 XXX Xxxxxxx current members should select option 3; Xxxxx, Xxxxx 00000 lenders that need to set up an account should select Option 4. Trans Union Corporation Call (000) 000-0000 to get the name of 555 West Xxxxx the local bureau to contact about setting Xxxxxxx, Xxxxxxxx 00000 up an account or obtaining other information.

  • Phone Number Email address .................................................................

  • Telephone Numbers Customer Service and Preauthorization: In state: 000-000-0000; Out of state: 0-000-000-0000; Hearing impaired: 711 Appeals: 000-000-0000 Preauthorization and notification for Behavioral Health services: 0-000-000-0000 Customer Service: In state: 000-000-0000; Out of state: 0-000-000-0000; Hearing impaired: 711 Home Delivery (Mail Order): 0- 000-000-0000 Preauthorization: 0-000-000-0000 Customer Service: In state: 000-000-0000; Out of state: 0-000-000-0000; Hearing impaired: 711 Customer Service and Appeals: 0-000-000-0000 Website: xxx.xxxxxx.xxx xxx.xxxxxx.xxx xxx.xxxxxx.xxx xxx.xxxxxx.xxx Fax: Appeals: 000-000-0000 Preauthorization and Appeals: 0-000-000-0000 Not Applicable Appeals: 0-000-000-0000 Mailing address to file a claim: Blue Cross & Blue Shield of Rhode Island Claims Department 000 Xxxxxxxx Xxxxxx Xxxxxxxxxx, XX 00000 Prime Therapeutics, LLC. P.O. Box 21870 Lehigh Valley, PA 18002-1870 Blue Cross & Blue Shield of Rhode Island Dental Claims Administrator P.O. Box 69427 Harrisburg, PA 17106-9427 Blue Cross Vision c/o EyeMed Vision Care Attn: OON Claims P.O. Box 8504 Mason, OH 45040-7111 Mailing address to submit an appeal: Blue Cross & Blue Shield of Rhode Island Grievance and Appeals Xxxx 000 Xxxxxxxx Xxxxxx Xxxxxxxxxx, XX 00000 Prime Therapeutics, LLC. Clinical Review Dept. 0000 Xxxxxxxxx Xxxxxx Xxxxx Xxxxx, XX 00000 Blue Cross & Blue Shield of Rhode Island Dental Customer Service – Appeals P.O. Box 69420 Harrisburg, PA 17106-9420 EyeMed Vision Care Attn: Quality Assurance Dept. 0000 Xxxxxxxxx Xxxxx Xxxxx, XX 00000 BCBSRI Customer Service Department Call Center hours are: • Monday thru Friday 8:00 AM to 8:00 PM • Saturday thru Sunday 8:00 AM to 12:00 PM Your Blue Store You may also visit one of our retail walk-in service centers. Please check our website for specific locations and business hours.

  • Access to Telephone Numbers Carrier is responsible for interfacing with the North American Numbering Plan administrator for all matters dealing with dedicated NXXs. BellSouth will cooperate with Carrier in the provision of shared NXXs where BellSouth is the service provider.

  • Telephone Service Notwithstanding any other provision of this Lease to the contrary:

  • Telephone No ( ) - Fax No.: ( ) - E-mail Address: IN WITNESS WHEREOF, two (2) identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Principal and Surety above named, on the day of , 20 . Principal (Name of Principal) (Signature of Person with Authority) (Print Name) Surety (Name of Surety) (Signature of Person with Authority) (Print Name) (Name of California Agent of Surety) (Address of California Agent of Surety) (Telephone Number of California Agent of Surety) Contractor must attach a Notarial Acknowledgment for all Surety's signatures and a Power of Attorney and Certificate of Authority for Surety. The California Department of Insurance must authorize the Surety to be an admitted surety insurer. PAYMENT BOND PAYMENT BOND -- Contractor's Labor & Material Bond (100% of Contract Price) (Note: Contractors must use this form, NOT a surety company form.) KNOW ALL PERSONS BY THESE PRESENTS:

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!