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Mail Service Pharmacy

Amendments

There is no charge for the amendment process.  The amendment should be submitted to the State of Nebraska within 30 days of the effective date of change.

If the Nebraska licensed pharmacist leaves employment at the facility, the facility must halt all shipments and deliveries to Nebraska patients until such time that the facility has completed the amendment process.
 

If you need to make more than one amendment to the license, you may check all boxes that are applicable on the same amendment form and submit the required information for each amendment being processed.

Pharmacist-In-Charge (PIC) change:  (This is not the same designation as the Nebraska licensed pharmacist.  The PIC is the person designated on the facility’s home state license.) 

The facility will need to send in the following:

  • A completed pdf icon amendment with the Pharmacist-In-Charge box checked;
    AND
  • A copy of his/her state pharmacist license from the state in which the facility is located

NE licensed pharmacist change:

The facility will need to send in the following:

  • A completed pdf icon amendment with the Nebraska licensed pharmacist box checked

Change of location, name of facility, or anything that would change the information available on your home state license (except for ownership change):

The facility will need to send in the following:

  • A completed pdf icon amendment with the location, name, or other box checked; AND
  • A copy of the facility's home state license showing that the change being requested has been made to the home state license

Ownership change:

The facility will need to send in the following:
  • A completed pdf icon Amendment for Change of Ownership (NOTE: If there has been a change to the ownership structure without change to the ownership name, please just send a letter of notification to outline the change in ownership).
     
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