*Online Refill requests are processed faster than calling the office. Please allow upto 72 hours for your request to be processed.

Your Contact Information

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Last Name:
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Your Pharmacy Information

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Medication # 1

Name of the Medication:
Dose (strength):
Quantity (Number of tablets):

Medication # 2

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Quantity (Number of tablets):

Medication # 3

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Medication # 4

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Medication # 5

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Contact

Phone

Hemet Office: (951)652-5000
Menifee Office:(951)672-1866
Corona Office: (951) 256-1779
Temecula Office: (951)303-1500
Riverside Office: (951)924-6500
San Bernardino Office: (909)567-2917

Fax Numbers:

(855)306-0133 - Pharmacy
(855)306-0134 - Labs, Radiology
(855)306-0135 - Authorizations