Note to Health Care Providers:  Drug Mart is now signed up to accept e-Rx. You may e-prescribe via Surescripts - Rx Hub.  You may also call the pharmacist at (718) 562-6637. Alternatively, you may fax the prescription to (718) 562-5031.

Already have a prescription?
  • If you have a prescription from your health care provider, Drug Mart can fill your prescription.
  • Bring your paper prescription to Drug Mart, and the pharmacist will dispense your medication.  Order your medication, and have it mailed to your home. We will need your paper prescription before dispensing the medication. To get started, please fill out the Confidential Patient Profile below.
    •  
    Your Information is confidential with us..
    First Name:         
    Last Name:                  Gender:

    Mailing Address: 
    City:                      
    State:                      Zip Code:

    Email Address:   

    Home Phone:          Cell Phone:       Work Phone:

    Birth Date:          

    Do you have Insurance Card?

    Name of Insurance:

    List any Drug Allergies (If applicable):

    List current medicines:     

    Comments