Transcription of FAX TO: CUSTOMER APPLICATION - McKesson | …
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FAX TO: CUSTOMER APPLICATION - McKesson | …
McKesson Corporation and its affiliated companies (collectively referred to as McKesson ) fax to : _____ CUSTOMER APPLICATION (Please print in block letters) CD01-S Business Type: Acute Primary Care Specialty Home Health Extended Long Term Pharmacy Closed Door Internet Mail Order Supplier Government Other_____ Legal Company Name Website Address Federal Tax ID Legal Address (Main Office) City State Zip Contact Name we may call for questions regarding this APPLICATION Title Phone Billing / Statement Address (if different than Main Office) City
McKesson Corporation and its affiliated companies (collectively referred to as “McKesson”) FAX TO: _____ CUSTOMER APPLICATION (Please print in block letters) CD01-S V.11-09 Business Type:
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