Businesses

Business Applications & Forms

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. 

If you are a Nevada Manufacturer or Nevada Warehouse, please send an email request to pharmacy@pharmacy.nv.gov for the application.

Pharmacy

**Pharmacy, Wholesaler, MDEG, Warehouse, and Manufacturer applicants, you may confirm the placement of an application on the Board’s next agenda by clicking the 'Board' menu on the gold bar and selecting "Board Meetings & Agendas". Do NOT call the Board’s office prior to checking.

Pharmacy Application

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2022 Pharmacy Application Fillable PDF.pdf

Ambulatory Surgery Center and Recovery Room

Ambulatory Surgery Center and Recovery Room

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2021 Ambulatory Surgical Center and Recovery Center 09.02.2021.pdf

Wholesaler

**Pharmacy, Wholesaler, MDEG, Warehouse, and Manufacturer applicants, you may confirm the placement of an application on the Board’s next agenda by clicking the 'Board' menu on the gold bar and selecting "Board Meetings & Agendas". Do NOT call the Board’s office prior to checking.

2022 Wholesaler Application

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2022 Wholesaler Application FINAL Fillable PDF.pdf

Cash Deposit

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Cash_Deposit.pdf

Certificate of Deposit

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/CertificateOfDeposit.pdf

Fingerprint Submission Instructions

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Fingerprint Submission Instructions - Effective 7-1-19.pdf

Letter of Credit

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Letter_Of_Credit.pdf

Surety Bond

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/SuretyBond.pdf

Outsourcing Facility

(includes 503A, 503B and FDA)

Out-Of-State Outsourcing Facility

html document/uploadedFiles/bopnvgov/content/Services/newapps/OOS OUTSOURCING FACILITY.pdf

Medical Products Provider - Medical Devices, Equipment and Gases (MDEG)

**Pharmacy, Wholesaler, MDEG, Warehouse, and Manufacturer applicants, you may confirm the placement of an application on the Board’s next agenda by clicking the 'Board' menu on the gold bar and selecting "Board Meetings & Agendas". Do NOT call the Board’s office prior to checking.

2022 MDEG Application

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2021 MDEG Application Revision FINAL.pdf

2022 MDEG Administrator Form

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2022 MDEG Administrator Application Fillable PDF 06.21.2022.pdf

Shared Inventory Site

Oncology Group Practice - Shared Inventory Site

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Oncology Group Practice - Dispensing Practitioner Shared Inventory SIte Application 10.19.22 PDF.pdf

Reproductive Healthcare Center Group Practice - Shared Inventory Site

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Reproductive Healthcare Center Group Practice - Shared Inventory Application 02.15.2023 PDF.pdf

Documents for All Types of Businesses

Designated Representative Form

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2022 Designated Representative Application Form Fillable PDF.pdf

Internet Pharmacy Services Certification

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/ALL_InternetPharmacyServicesCert.pdf

License Verification Form (Only required for Out-of-State locations)

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2020 ALL_LicenseVerificationForm(1).pdf

Personal History Record Application

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2023 Personal History Application FINAL Fillable PDF.pdf

Sterile Compounding Questionnaire

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Sterile Compounding Questionnaire Fillable PDF.pdf

Narcotic Treatment Program

NTP

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/2020 NTP APP.pdf

Automated Dispensing Systems

Automated Drug Dispensing System Application - For Pharmacies

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Automated Drug Dispensing System Application - for Pharmacies 05.05.2023 PDF.pdf

Automated Drug Dispensing System Application - For Reproductive Healthcare Center

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Automated Drug Dispensing System Application - for Reproductive Healthcare Centers 05.05.2023 PDF.pdf

Mechanical Device Application

Mechanical Device Application

pdf document/uploadedFiles/bopnvgov/content/Services/newapps/Mechanical Device Application 05.05.2023 pDF.pdf