ALIGNRx Member Information ALIGNRx Pharmacy NamePharmacy Mailing Address Street Address City State / Province / Region ZIP / Postal Code Pharmacy Phone NumberNPI NumberNCPDP NumberUser Information(contact person who will implement the program) First Name Last Name Email UsernameThis will be the username for the pharmacy: (should include 1 uppercase letter, 1 lowercase letter, and 1 number)Cell # for 2-Factor AuthorizationTo log into your account, for added security, a text message containing a PIN will be sent to this mobile number.Additional User First Name Last Name Email PhoneAdditional User First Name Last Name Email Phone Δ
2530 Professional Road
2530 Professional Road