Medicine Shoppe #1576
1987 State Route 52 Colonial Square
Liberty, NY, 12754
Tel.: (845) 292-8200
Fax.: (845) 292-9083
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