Medicine Shoppe #1217
542 South Eufaula Ave
Eufaula, AL, 36027
Tel.: (334) 687-0021
Fax.: (334) 687-9821
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