Medicine Shoppe #1783
3903 S Cobb Drive, Ste 103
Smyrna, GA, 30080
Tel.: (770) 436-0811
Fax.: (770) 436-1810
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