January 16, 2019
A sample of the VDP Pharmacy Enrollment Application is now available to assist pharmacy staff. All required fields are highlighted to describe what a properly completed application should look like. Pharmacy staff are encouraged to review the completed examples prior to submitting their application to HHSC. Two examples of appendix A are also available, one for an entity and one for a person.
- Pharmacy Provider Enrollment Application example (PDF)
- Appendix A for entity submission example (PDF)
- Appendix A for person submission example (PDF)
Questions about the pharmacy enrollment process should be sent by email to HHSC.