Main Leader Drug Store
3685 Taylor Road
Loomis, CA, 95650
Tel.: (916) 652-7265
Fax.: (916) 652-8731
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