For all replacement/duplicate licenses, a $10.00 fee will be charged. Driver Licensing > Update Personal Information > Address Change. October 2018. An additional fee is not required 3. 0000060197 00000 n h�b``�``��c`c`�ab@ !�;��� �='f����P�#�'���iWTZ��芠��A/. Licensed Professions: Pharmacy. Pharmacy: Overview . Portable Document Format (.pdf). Name changes require legal documentation showing the name change. 0000248935 00000 n * 4. Please submit a request including your full name as it appears on your license, profession, license number, your new name, your date of birth, the last four digits of your social security number, and your signature. NH Pharmacist, Pharmacy Technician, or Pharmacy Intern License Number. 446 0 obj <>stream 0000248762 00000 n 0000097241 00000 n Ownership changes – A completed application showing the new ownership must be filed with the Board office with a $260.00 fee. ... Change Address Form. This rule provided a waiver for Pharmacist to achieve the Live, Hands on CPR requirement. 0000103392 00000 n Maintain documentation of pharmacy technician in-service records or technician in training daily logs available for inspection at the pharmacy. Personal License - Change of Name Form (Note: the file upload button may not work in Internet Explorer - you may use other browsers such as Firefox, Chrome, Edge or Safari if having trouble uploading documentation) 3. 0000024499 00000 n New Hampshire Pharmacy Licensure Board Contact Information; New Hampshire Board of Pharmacy 57 Regional Drive Concord, New Hampshire 03301-8518 To connect with New Hampshire Board of Pharmacy , sign up for Facebook today. Notify the Nevada State Board of Pharmacy of all employment changes of pharmacy staff within 10 days of the change. Personal License - Change of Email Address Form The Board must have a current/valid email address on file in or… startxref Type of License Held. On-line Change of Address Form; Fillable Change of Address Form (PDF) Name Change. To change your address, please submit a completed Record Change Request Form, a photocopy of your current driver license to any DMV Drop Box.You can purchase a replacement license with the new address for a $3.00 fee. * 4. Facilities: A change in ownership or location requires the submissionof a new application. 0000150283 00000 n Note: Third-party entities (persons outside of the licensed company/facility) cannot submit change forms on behalf of a licensee nor be the licensed company's contact person. * 2. 0000016678 00000 n The mission of the Board is to protect and promote the health of Mississippi citizens by regulating and controlling the practice of pharmacy and the distribution of prescription drugs and devices. Enable JavaScript by changing your browser options, and then try again. To change or update the name or address on your license online, you'll need: A new or existing account with ePLACE, the online permitting and licensing portal for the Division of Professional Licensure (DPL) The authorization code and record ID of the license you would like to make a change to if it is not already linked to your ePLACE account. 0000017583 00000 n Note: the file upload button may not work in Internet Explorer - you may use other browsers such as Firefox, Chrome, Edge or Safari if having trouble uploading documentation. * 2. The Board must have a current/valid email address on file in order to for you to receive your license as the Board only issues electronic licenses. An additional fee is not required 3. The Board continuously monitors the practice of pharmacy in New Hampshire through the ongoing inspection of pharmacies and all healthcare practitioners prescribing, dispensing, or administering prescription drugs/devices throughout the state in order to ensure that the citizens of New Hampshire continue to receive the safe, quality pharmaceutical care they have come to expect. The inspection will be similar to the one required for a new pharmacy; however, the Board does understand that in certain instances the library, shelving, etc. JavaScript must be enabled for some features to display properly. Pharmacies are welcome to post the brochures for distribution to their pharmacy customers. Communications are done through email, and many times Board communications are returned as undeliverable because of licensees not providing correct/updated email or mailing addresses. 0000022970 00000 n Please scan and email documentation, to the extent possible, to the email address found on each unit's homepage. Personal License - Change of Address Form 2. Recent budget cuts to New Hampshire’s Board of Pharmacy meant some compliance officers were laid off. 0000016416 00000 n 0000059731 00000 n If you are a pharmacist, pharmacy technician, pharmacy intern, or pharmacy facility, you can use these steps to request a name change, address change, and/or a duplicate license. The State Newsletter Program was created to promote compliance within the practice of pharmacy and is part of the NABP Foundation, which was created by NABP to support the Association’s educational programs and research and development projects. 032 ~ Pharmacist's Certification of Pharmacy Technician Practice in Non-Resident State 040 ~ Application for New Pharmacy Technician Certificate (revised 08-20) 090 ~ Notice of Change in Mailing Address 091 ~ Notice of Name Change 092 ~ Notice of Pharmacy Employment 201 ~ Product Order Form - Duplicate Credential . 0000022271 00000 n ), (Not for use for reporting 9-1-1 Address Change for a Pharmacy (PDF) Central Processing Center Pharmacy Application (PDF) ... << Previous Page Contact. 0000023403 00000 n 0000055412 00000 n 1 Page 1 January 2019. All applications are available on the ... New Hampshire Board of Pharmacy News. Pharmacists, Interns & Technicians may use the form below to report a change of address and/or change of employment via MAIL or FAX. will be moved from the old location at the time of the move. 0000023352 00000 n The mission of the New Hampshire Pharmacists Association is to promote, enhance, and advance pharmacy practice, in the State of New Hampshire by advocating for the professional interests of pharmacists, pharmacy technicians, student pharmacists, and ancillary pharmacy personnel as well as to advocate for the health and welfare of the general public. 0000016236 00000 n 0000024273 00000 n This includes name, address and employment. Health Related Boards Name and Address Change Request . ... New Hampshire Board of Pharmacy News. 121 S Fruit St, Ste 401, Concord, NH 03301-2412 • Tel: 603/271-2350 • Fax: 603/271-2856 * 3. “change of address” refers to those situations in which a pharmacy has been given a new address, but is still at the same physical location and has not been remodeled. 0000068305 00000 n 0000104169 00000 n 301 Centennial Mall South, Lincoln, Nebraska 68509 . 6/20 Sasser explained that after having passed legislation to create the advanced level of pharmacy technician, New Hampshire is currently in the process of defining their roles and requirements and to make recommendations to the board of pharmacy surrounding education, work experience, and more. eLICENSE GUIDE: APPLYING FOR A CHANGE IN BUSINESS DESCRIPTION. 0000064062 00000 n Minnesota Board of Pharmacy 2829 University Avenue SE, Suite #530 Minneapolis, MN 55414 Phone: (651) 201-2825 Fax: (612) 617-2262 Email: pharmacy.board@state.mn.us A completed application (OOSPH502) and license verification form must be submitted to the Office of the Professions at the mailing address at the end of the form whenever these changes occur. 0000068733 00000 n (NRS 639.540) 4. The Board of Pharmacy, along with the Office of Professional Licensure & Certification, has moved to a new location - 7 Eagle Square, Concord, NH. 0000015833 00000 n 0000149309 00000 n 0000098120 00000 n 0000097686 00000 n What must be done if I change jobs or change my home address? October 2018 News New Hampshire Board of Pharmacy. 0000248988 00000 n Corporate changes in ownership at the grandparent level or above, only require the submission of a letter on company letterhead, which includes the NH facility license number, date of change, and old and new ownership structure or organizational chart. Box 2649. Please Print or Type . 3. If you are changing your name, you must submit a copy of the legal document that changes your name(i.e. 0000055439 00000 n 0000024387 00000 n as applicable depending on your license type. www.nh.gov/pharmacy. 0000015300 00000 n 0000019160 00000 n Complete Legal Name. The Board has developed a printable brochure for use by consumers in New Hampshire on the proper disposal of unused medication. If the OBTAIN SECURITY CODE feature does NOT work, please send an email to new.license@pharmacy.ohio.gov and include the license number to request the security code. * 3. Board Licensing Update. 0000024569 00000 n Pharmacist Address and Email Changes . The New Hampshire Board of Pharmacy (NHBP) regulates the profession of Registered Pharmacist in New Hampshire. Licensee Verification. Contact the Board's office at (401) 222-2828 to obtain the proper application. NEW HAMPSHIRE BOARD OF PHARMACY. Published to omote compliance of pr pharmacy and drug law. NOTE: A change in the Pharmacist-in-Charge requires written notification to the BOARD. “change of address” refers to those situations in which a pharmacy has been given a new address, but is still at the same physical location and has not been remodeled. Communications are done through email, and many times Board communications are returned as undeliverable because of licensees not providing correct/updated email or mailing addresses. Box 45013 Newark, New Jersey 07101 Incoming Pharmacist-In-Charge Acknowledgement I agree to assume the duties and responsibilities of the pharmacist-in-charge at the above pharmacy and am aware of my personal liability for violations of any New Jersey Pharmacy laws. 0000103146 00000 n Main Telephone: (603) 271-2152, (Note: the file upload button may not work in Internet Explorer - you may use other browsers such as Firefox, Chrome, Edge or Safari if having trouble uploading documentation). Submit a complete mail service pharmacy application (NOTE: On page 1, question 1 of the application, please list the name of the facility exactly as it appears on the home state pharmacy license. %PDF-1.6 %���� STATE OF NEW HAMPSHIRE BOARD OF NATUROPATHIC ... - (603) 271-6762 Fax - (603) 271-6702 CHANGE OF ADDRESS FORM (Please assure ... #_____ Your mailing address is available to the public. The California State Board of Pharmacy is encouraging licensees to determine their eligibility for relief, which includes Tax Relief for Businesses Impacted by COVID-19, $500 Million for New COVID Relief Grant for Small Business, and Increase Funding for the California Rebuilding Fund. Use the gray tool bar to navigate to the department or professional board you need to get in touch with. This form or other changes can be sent to our office via: FAX (505) 222-9845 E-Mail: pharmacy.board@state.nm.us MAIL: NMBOP, 5500 San Antonio Drive NE, Suite C, Albuquerque, NM 87109. 0000016595 00000 n can either select to enter the businesses current e-mail address that is on file with the Board for correspondence OR by entering the businesses FEIN number. 12091 Bricksome Avenue, Suite B Baton Rouge, LA 70816 Phone: 225-295-8567 Fax: 225-295-8568 0000148434 00000 n The NHBP reviews the credentials of foreign pharmacy graduates directly. 0000192225 00000 n On page 1, question 5 of the application, make sure that the list of RPs working at the pharmacy's location you are attempting to license is a complete list of all RPs working at the location. 0000001771 00000 n Agenda Review: Move off consent ... 2020, moved to item 16. 0000248882 00000 n If the Board office is not notified, the pharmacist/pharmacy or technician is in violation of Rules of the Board. * 1. DATE LICENSE # D.O.B. 0000154011 00000 n At this time, all pharmacists are required to submit the CPR Certification as defined in Ph 1303.01. NEW HAMPSHIRE BOARD OF PHARMACY Non-Resident / Mail-Order Pharmacy or Bulk Compounding / Outsourcing Facility (503B) Change of Pharmacist-In-Charge: Question Title * 1. 7 Eagle Square |  Concord, NH 03301 The West Virginia Board of Pharmacy presents the information on this website as a service to the public. NEW HAMPSHIRE BOARD OF PHARMACY. (402) 471-3121 T:(614) 466.4143 | F:(614) 752.4836 | contact@pharmacy.ohio.gov | www.pharmacy.ohio.gov. New Jersey Office of the Attorney General Division of Consumer Affairs Board of Pharmacy 124 Halsey Street, 6th Floor, P.O. New Jersey Division of Consumer Affairs ... Use the gray tool bar to navigate to the department or professional board you need to get in touch with. Change your contact information, employer information, corporate officers, shareholders, opioid production information, etc. If the Board office is not notified, the pharmacist/pharmacy or technician is in violation of Rules of the Board. 0000055996 00000 n You are required to notify the board within thirty (30) days of changing your name and/or address. Return this completed form to: New York State Educatio n Department, Office of the Professions, State Board of Pharmacy, 89 Washington Avenue, Albany, NY 12234-1000 Form PB 327, Page 3 of 3, Rev. Office of Professional Licensure and Certification The Mississippi Board of Pharmacy was established by legislative action in 1920. Licensee Name: _____ License Number: _____ 0000151161 00000 n Change in address or job must be reported to the New Hampshire State Board of Pharmacy within 15 days in writing via email (pharmacy.board@nh.gov), mail or fax. * 1. 0000248822 00000 n Important Information About Your Address of Record . 0000069195 00000 n Business/Facility Licenses (Non-Resident / Mail-Order Pharmacies, Prescription Drug/Device Manufacturers/Wholsalers/Distributors, Brokers, 3PL's, Bulk Compounding/Outsourcing Facilities, Limited Retail Drug/Device Distributors, etc.) 0000021533 00000 n 0000063735 00000 n 0000048688 00000 n 375 72 You are required to notify the board of any change in name within 30 days. P.O. 2 Revision 07/12/2019 Nonresident Pharmacies Only: New Applicants - The inspection requirements identified in rule 657 IAC 19.2 must be satisfied prior to submitting an application for licensure. 0000019967 00000 n 0000194396 00000 n A New York State professional license is valid for life unless it is revoked, annulled, or suspended by the Board of Regents. 0000149914 00000 n Visit nh.gov for a list of free .pdf readers for a variety of operating systems. Download the Change of Address or Name or Duplicate License Form Log in to the Online Licensing portal Subscribe to the New Hampshire State Board of Pharmacy Newsletter email alert. Pharmacy and firms information and tools to become a licensed pharmacy firm. Ownership changes at the direct parent level of the licensed facility require the submission of a new application and fee for all business/facility licenses. What must be done if I change jobs or change my home address? New ... https://www.oplc.nh.gov/naturopathic-exa... - 52120 bytes [application/pdf] - … Pharmacy and firms information and tools to become a licensed pharmacy firm. Prior to issuance of the new permit to the new location, a change of location inspection must be completed by a Department of Health Inspector. Due to the ongoing COVID-19 situation, the new office is not yet open to the public for walk-in service. There are now only two employees left to … 0000150656 00000 n 0000015884 00000 n Offices remain closed to the public due to the public health emergency, however, staff is working remotely. NH Pharmacist, Pharmacy Technician, or Pharmacy Intern License Number. Change in address or job must be reported to the New Hampshire State Board of Pharmacy within 15 days in writing via email (pharmacy.board@nh.gov), mail or fax. The brochure is a public service of the Board of Pharmacy and can be freely distributed and duplicated as needed. 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New... https: //www.oplc.nh.gov/naturopathic-exa... - 52120 bytes [ application/pdf ] …. Employees left to … Resident Instate Pharmacy change of address may be made on-line or in writing the... 402 ) 471-3121 Pharmacy and firms information and tools to become a licensed Pharmacy firm Interns Technicians... Browser options, and then try again s Fruit St, Ste 401, Concord, nh •! Mississippi Board of Pharmacy meant some compliance officers were laid off name and/or address drivers to notify Board. A pharmacist-in-charge ( PIC ) change must be done if I change jobs or my.