The Mail Order Pharmacy application is the form packet that the Montana Board of Pharmacy, within the Montana Department of Labor and Industry's Business Standards Division, uses to register out-of-state mail service pharmacies that ship prescription drugs or devices to patients in Montana. A pharmacy located in another state completes it, together with the personal history questions and companion forms in the packet. On FillingPDF you can fill out the form online and download or print the completed PDF; the Board publishes the original at boards.bsd.dli.mt.gov and takes applications through its own channels.
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What is Mail Order Pharmacy – Montana?
The Mail Order Pharmacy application is the Montana Board of Pharmacy packet an out-of-state pharmacy completes to register as an Out-of-State Mail Service Pharmacy before shipping, mailing or delivering prescription drugs or devices to patients in Montana.
The packet states the registration requirements under 24.174.1001-1009 ARM and contains several parts:
- The application itself (lines 1 to 24), marked either New Application or Location/Ownership Change Application.
- Personal History Questions 1 to 18, followed by the applicant's release and signature.
- The application for Montana Dangerous Drug Act Registration, for pharmacies that dispense controlled substances (50-32-301 MCA and ARM 24.174.1401).
- Two verification forms, one for business licensure and one for pharmacist licensure, which the state board where the business is located or the pharmacist is employed completes and returns directly to the Montana Board.
- The Pharmacist-in-Charge Form, the Statement of Pharmacist-in-Charge, and the Pharmacist-in-Charge Agreement (Non-Pharmacist Owner).
When a routine application is processed and approved, the Board issues a permanent registration. The packet is for out-of-state mail service pharmacies; it does not cover a business operating in Montana without registration, which the form says is not permitted in any manner.
Who needs to file Mail Order Pharmacy – Montana?
Out-of-state pharmacies that ship, mail or deliver prescription drugs and/or devices to a patient in Montana apply on this packet, because no out-of-state pharmacy may do so unless it is registered by the Montana Board of Pharmacy.
Conditions the form attaches:
- The applicant must be a legal entity registered and in good standing with the Montana Secretary of State, with a registered agent in Montana for service of process.
- A pharmacy that conducts online pharmacy services must be registered and in good standing with the National Association of Boards of Pharmacy (NABP) Digital Pharmacy Accreditation (formerly VIPPS).
- A pharmacy that provides home infusion therapy to Montana must also be licensed with the Department of Public Health and Human Services (DPHHS).
- A pharmacy that will dispense controlled substances also completes the Dangerous Drug Act application.
- The pharmacist-in-charge of dispensing to Montana must be licensed in good standing in the state where the pharmacy is located; Montana licensure is not required.
- If the owner is not the pharmacist-in-charge, the Pharmacist-in-Charge Agreement (Non-Pharmacist Owner) is also submitted.
On the personal history questions, a business entity answers through the individuals authorized to answer for it; where persons in charge are involved, those associates or agents answer personally.
When to file Mail Order Pharmacy – Montana
Apply before the pharmacy ships, mails or delivers prescription drugs or devices to any patient in Montana, since no out-of-state pharmacy may do so without Montana registration. For a routine application, allow up to 30 days from the date the Board has a complete file; a non-routine application, which may require more information, a personal appearance or Board consideration, may take up to 120 days.
Later events require a new filing or notice:
- A move to a different physical location voids the original license; submit a new application for the new location at least 30 days before the change.
- A change of ownership, meaning more than 50 percent of the equitable ownership transferred in one transaction or a related series, voids the license; the new owner submits a new application at least 30 days before.
- Transfers of five to 50 percent of the equitable ownership require written notice to the Board.
- If the pharmacist-in-charge leaves, a new one must be designated in writing on the board-approved form within 72 hours.
Documents you need
- Copy of your current DEA registration, if applying for Dangerous Drug Dispenser Registration (the Dangerous Drug Act application also asks for it).
- Copy of the last state inspection (line 19 asks for the date and a copy).
- Copy of a Technician Utilization Plan; where the home state regulates pharmacy technicians, also the supervisor-to-technician ratio (line 21).
- Proof of Montana DPHHS licensure, if the pharmacy provides home infusion therapy to Montana.
- Proof of registration with the Montana Secretary of State: the Certificate of Authority (foreign business) naming the entity and its registered agent.
- NPDB self-query on an organization; the results are forwarded to the Board in the original sealed envelope.
- Verification of licensure in good standing from the state where the business is located (line 22), returned directly by that state board.
- Verification of licensure in good standing of the pharmacist-in-charge from the state where employed (line 23).
- Proof of NABP Digital Pharmacy Accreditation (formerly VIPPS) standing, if the pharmacy conducts online pharmacy services (lines 10 and 11).
- Pharmacist-in-Charge Form and Pharmacist-in-Charge Agreement (Non-Pharmacist Owner), the latter only if the owner differs from the pharmacist-in-charge.
- Separate sheet listing all states where the business has an active license, if line 24 needs more room.
How to fill out Mail Order Pharmacy – Montana
Choose the application type
At the top of the application page, check New Application or Location/Ownership Change Application. A location or ownership change brings a new license number and ends the old one.
Enter pharmacy identification details
Lines 1 to 5: pharmacy name, address, email, resident state license number, DEA number, telephone, fax, Tax ID # and toll-free telephone and fax numbers.
Report any Montana license history
Line 6: give the license number and business name if currently or previously licensed in Montana. If currently licensed, check Location, Ownership or Other for the reason for closure and enter the date to close or terminate the existing license.
Identify the pharmacist-in-charge
Line 7: name of the Registered Pharmacist-in-Charge of dispensing to Montana, with state license number and the state of licensure and practice. Line 8: check YES or No for whether that pharmacist has read the Montana Board of Pharmacy statutes and rules.
Describe services and online pharmacy status
Line 9: describe the scope and type of services. Line 10: check Yes or No for online pharmacy services; if yes, line 11 asks for the name under which the NABP Digital Pharmacy Accreditation is listed.
Mark ownership, drugs and home infusion
Line 12: check Sole Proprietor, Partnership, Corporation or Other and attach the required information. Line 13: check Controlled Substances and/or Non-Controlled Prescription Drugs/Devices. Line 14: check Yes or No for home infusion therapy; if yes, line 15 requires proof of DPHHS licensure.
Enter Secretary of State registration
Line 16: date of registration with the Montana Secretary of State under ARM 24.174.1002. Line 17: the name under which the business is registered. Line 18: the Agent of Record in Montana for service of process.
Cover inspection, records and technicians
Line 19: date of last state inspection, with a copy attached. Line 20: the method used to keep readily retrievable records of sales to Montana individuals. Line 21: whether technicians are regulated in your state and, if yes, the ratio allowed, with the utilization plan.
Complete the verification lines
Lines 22 and 23: enter state license number, issue date, expiration date and license type for the business and for the pharmacist-in-charge, and mark whether verification was requested. Line 24: list all states where the business has an active license.
Answer the personal history questions
Check Yes or No for questions 1 to 18. Each Yes answer will bring a request for specific information, and the application is not complete until staff receive it.
Sign and add companion forms
Sign and date the applicant release. Complete the Dangerous Drug Act application if you will dispense controlled substances, and the Pharmacist-in-Charge Form and agreement as needed.
Review and download the completed PDF
Check every line and attachment, then download or print the completed PDF from FillingPDF and assemble the package described under How to submit.
How to submit Mail Order Pharmacy – Montana
The packet goes to the Montana Board of Pharmacy by mail or by delivery to the addresses printed on the form; the Board's staff email is for questions.
- Mail: Montana Board of Pharmacy, P. O. Box 200513, Helena, Montana 59620-0513.
- Delivery: Montana Board of Pharmacy, 301 S Park, 4th Floor, Helena, MT 59601.
- Questions: [email protected], www.pharmacy.mt.gov, or (406) 841-2300 as printed on the Pharmacist-in-Charge Agreement page.
Include copies on 8 ½" x 11" paper of the documents listed on the form. Fees apply and are non-refundable: an application fee and, for the Dangerous Drug Act registration, a dispenser fee. Pay by check or money order payable to the Montana Board of Pharmacy; the current amounts are printed on the form.
The licensure verification forms are not sent with the application: mail them to the state board where the business is located or the pharmacist-in-charge is employed, which returns them directly to the Montana Board. Contact that state board first, because some charge a fee. The National Practitioner Data Bank (NPDB) self-query results are forwarded to the Board in their original sealed envelope. Illegible and incomplete applications are returned, and the Board notifies you in writing of deficient or missing items. FillingPDF lets you fill out and download the PDF; submission follows the Board's channels above.
Common mistakes to avoid
- Submitting an illegible or incomplete application; the form says these are returned.
- Shipping or dispensing to Montana patients before the registration is active; the form says businesses may not operate in Montana in any manner without it.
- Opening the NPDB self-query results instead of forwarding them to the Board in the original sealed envelope.
- Sending the licensure verification request to the Montana Board instead of the state board where the business or pharmacist is located, or skipping the call about a possible verification fee.
- Omitting the Certificate of Authority that identifies the entity and its registered agent in Montana.
- Giving an incomplete or false answer to the personal history questions; the form calls it unprofessional conduct that may lead to denial or revocation.
- Moving locations or changing ownership without submitting a new application at least 30 days before the change.
- Checking the wrong application type at the top, or leaving the line 6 closure reason blank when replacing a Montana license.
- Paying with anything other than a check or money order payable to the Montana Board of Pharmacy.
Frequently asked questions
Do I need a mail order pharmacy registration to ship to Montana patients?
Yes. The Montana Board of Pharmacy form states that no out-of-state pharmacy may ship, mail or deliver prescription drugs and/or devices to a patient in Montana unless it is registered by the Board. This application is how an out-of-state mail service pharmacy applies.
How long does the Montana mail order pharmacy application take to process?
A routine application takes up to 30 days from the time the Board has a complete file. A non-routine application, which may involve additional information, a personal appearance or Board consideration, may take up to 120 days. Missing items are reported to you in writing.
Does the pharmacist-in-charge need a Montana license?
No. The pharmacist-in-charge of dispensing to Montana must be licensed in good standing in the state where the out-of-state pharmacy is located; Montana licensure is not required. The pharmacist must also be listed on the application and comply with Montana laws and rules.
Is there a fee for the mail order pharmacy application?
Yes. The form lists a non-refundable application fee and a separate non-refundable fee for the Montana Dangerous Drug Act dispenser registration. Pay by check or money order payable to the Montana Board of Pharmacy; the current amounts are printed on the form.
Where do I send the Montana Board of Pharmacy application?
Mail it to Montana Board of Pharmacy, P. O. Box 200513, Helena, Montana 59620-0513, or deliver it to 301 S Park, 4th Floor, Helena, MT 59601. Questions go to [email protected].
What if my mail service pharmacy moves or changes owners?
A move to a new physical location or a change of ownership voids the original license. Submit a new application at least 30 days before the change. Ownership transfers of five to 50 percent only require written notice to the Board.
Do I also need the Dangerous Drug Act application?
Only if the pharmacy will dispense controlled substances. That registration also requires a copy of your current DEA registration, plus the Montana license number if you already hold a mail order license and are adding dispensing.
Can I fill out the Mail Order Pharmacy application online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is independent of the Montana Board of Pharmacy and does not submit applications; you send the package to the Board through its channels.
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