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Pfizer Patient Assistance Program

Pfizer Patient Assistance Program

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Prescribers in all other states only need to submit a state-specific blank if it’s required in their state, and the application is mailed. To e-Prescribe, send prescription via e-Prescribe to AmeriPharm/MedVantx, 2503 E. 54th Street N, Sioux Falls, SD 57104 (NPI Number: 1073692745; NCPDP number 4351968) Vfend: 50 mg, 30-day supply

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