Medicine Shoppe #1131
605 N Shamokin St
Shamokin, PA, 17872
Tel.: (570) 648-5242
Fax.: (570) 648-3606
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