Become a customer
We’re happy to have you join us!
Before you begin the application, please make sure you’ve gathered the necessary documentation.
We collect general business, contact, and billing information for your pharmacy during the application process as well as the following required documentation (saved as a JPG, PDF or PNG):
- DEA license or HIN
- State Board of Pharmacy license
- State Sales & Use Tax exemption ID# or certificate (FL, WA, LA only)
For businesses that are applying for credit up to $25,000, additional information required depends on how you choose to pay:
- For EFT or Biller Direct forms of payment, please upload a voided bank check, or a letter from your bank validating: company name, bank account number, and transit routing number
- For credit card payment, no information is required at this time
Need assistance with your application? Want to learn more about working with us? Please call 866-638-1464 and select option 3 or email SalesAdmin@SmartSourceRx.com for support.