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Businesses

Do NOT use for Renewals

As of July 1, 2011: ONLY Cashier’s Checks or Money Orders will be accepted. NO Cash or Personal Checks will be accepted. Should an application be received on July 1 and after without the proper payment option, it will be returned. We do not accept credit cards for new applications. There are no exceptions.
 
Look over each choice carefully as it applies to your type of business. If you submit applications that are combined they will be returned without being processed.
 
Business Applications
 
Pharmacy
  Nevada - For locations located in the state of Nevada (pdf)
  Out-of-State – For locations shipping to the state of Nevada (pdf)
   
Wholesaler
  Nevada - For locations located in the state of Nevada (pdf)
  Out-of-State – For locations shipping to the state of Nevada (pdf)
   
Medical Devices, Equipment and Gases (MDEG)
  Nevada - For locations located in the state of Nevada (pdf)
  Out-of-State – For locations shipping to the state of Nevada (pdf)
   
Documents for All Types of Businesses:
  Designated Representative Form (pdf)
  Internet Pharmacy Services Certification (pdf)
  License Verification Form (Only required for Out-of-State locations) (pdf)
  MDEG Administrator Form (pdf)
  Personal History Record Application (pdf)
   
Documents for Wholesalers Only:
  Cash Deposit (pdf)
  Certificate of Deposit (pdf)
  Fingerprint Authorization Form (pdf)
  Letter of Credit (pdf)
  Surety Bond (pdf)
   
  Narcotic Treatment Program
  NTP (Interactive pdf)
   
*If you are a Nevada Manufacturer or Nevada Warehouse, please send an email request to pharmacy@pharmacy.nv.gov for the application.
   
 
(Interactive PDF -or- I-PDF) - What is it? How do I work with it?


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