877-336-3895

Customer registration

Become a Customer

Approval is typically fast. Complete the form below to get started.

A Pharmsource account representative welcoming a new customer

Getting started

To become a customer of Pharmsource, please complete the form below. In addition, you will need to fill out the Payment Authorization Form.

Pharmsource account team ready to help new customers get set up

Need help?

Company

Tell us about your pharmacy or business.

Only needed if you plan to purchase controlled substances.

Contact Information

Who should we reach out to about this account?

Fields marked * are required.

Payment Authorization Form

Complete the Payment Authorization Form online to finish setting up your account.

Payment Authorization Form
Pharmsource distribution center fulfilling pharmacy orders for active accounts

Getting started

Apply online and start ordering fast

Complete the registration form to open your Pharmsource account. Approval is typically fast, and once your account is active you can start placing wholesale orders. Submit the Payment Authorization Form to finish setting up.