Out of State Mail Service Pharmacy Application Requirements and Fees

 
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Facilities
 
 
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What you need to know

​To apply for a mail service pharmacy license, a facility must:

  • Hold a pharmacy license or permit issued by and valid in the state in which the facility is located and from which such prescription drugs will be shipped, mailed, or otherwise delivered.
  • Employ at least one pharmacist who works on-site at the facility and holds a current unrestricted Nebraska pharmacist license issued under the Uniform Credentialing Act who shall be responsible for compliance with the Mail Service Pharmacy Licensure Act. Please click here to be routed to the pharmacist page for applications, name/address change, or duplicate/reissuance of a pharmacist's Nebraska credential. 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 an amendment form.

Mail service pharmacy application All mail service pharmacy licenses expire annually on the anniversary date of issuance.


The applicant pharmacy must:

  1. Submit a complete mail service pharmacy application (NOTE: On page 1, question 1 of the application, please list the name of the facility exactly as it appears on the home state pharmacy license. On page 1, question 5 of the application, make sure that the list of RPs working at the pharmacy's location you are attempting to license is a complete list of all RPs working at the location. List them again, even if you mention them elsewhere in the application);
  2. Submit copies of the last two on-site inspections completed by the home state for the facility at the address noted on application (NOTE: If you have not had 2 inspections completed by the regulating agency in your state, you should create a memo explaining this situation. Make sure that these inspections are fully readable. If you are unable to make a fully readable copy of your inspections, you will need to contact your state board and have them make a copy from their originals for you to send with your application);
  3. Submit a check for the $625 application fee made payable to DHHS Licensure Unit;
  4. Contact your state Board and have them send directly to Nebraska a certification (see definition of certification under Certification/Verification of Licensure) of your facility's license and your PIC (RP designated on the facility's home state license as the PIC); and
  5. If your facility, PIC, and/or Nebraska licensed pharmacist has been subject to any disciplinary action(s) on a license in any state, please answer yes to the appropriate questions on page 3 of the application and supply a letter of explanation and documentation related to the discipline. Failure to report discipline could result in Disciplinary action imposed upon Nebraska licensure or denial of Nebraska licensure.
  6. All supporting documentation and licensure of a Nebraska licensed RP are required to complete the application process. Payments for the Pharmacist license in Nebraska must be paid directly by the applicant pharmacist or, if paid by the employing pharmacy, such payment must be accompanied by a completed W-9 form. No application for a mail service permit shall be retained by the Department for more than 150 days from the date the mail service permit application is received by the Department. If such documentation and Nebraska RP licensure is not completed within this time, the application and supporting documentation will be destroyed and a refund will be processed, less the administrative fee of $25.