Medicine Shoppe #0891
30 W Park Ave
DuBois, PA, 15801
Tel.: (814) 371-0800
Fax.: (814) 371-7322
Request a refill for your medication(s)
Please note that this form allows you to submit up to 5 prescriptions for refill. If you would like to submit more than 5 prescriptions for refill, please complete additional submission forms.


Rx Number(s)

Numbers only
NO letters or dashes