Medicine Shoppe #0445
1357 W Innes St
Salisbury, NC, 28144
Tel.: (704) 637-6120
Fax.: (704) 633-6027
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