Preferred Medical Network - One Source. Many Solutions.

Instant Rx Reorder

Phone 1-888-586-4650 or Fax 502-489-5045
Email instantrx@preferredmedical.net

Please complete this entire form to reorder a supply of Instant Rx cards to be delivered within 7 to 10 business days. For immediate needs, call us at 1-888-586-4650 to have a card sent via fax or email, or to have us contact the pharmacy with billing information.
Items in red are required

Ordering Information

Company:
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Contact First Name:
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Contact Last Name:
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Email:
Required: Please enter your email address.
Address:
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City: State: Zip:
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Phone:  -  -
Required: Please enter area code.
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Number of Cards:  25  50  Other
Required: Please enter number of cards.