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- <title>OmniMD - Physician Empowered » Patient Demographics </title>
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- <table id="tableTop" cellpadding=0 cellspacing=0 border=0 width="100%"><tr><td width="80%" style="padding-bottom:5px;padding-left:10px;" valign=bottom nowrap><img border="0" src="/vis/clientlogo.gif" hspace=20><b>Ms. Chatoya Pettway, <a href="javascript:selectLocationLookup()"><span id=locId>Dean R Martin MD, FACOG, PC</span></a>, Brooklyn Obstetrics & Gynecology Care PC</b></td><td width="20%" align=right><a href="http://www.omnimd.com/"><img border="0" src="/vis/logoSmall.gif" width="132" height="50" hspace=20></a></td></tr><tr><td colspan=2 bgcolor=black><img src="/vis/trans.gif" width="1" height="2"></td></tr></table><!---border table starts--><table cellpadding=0 cellspacing=0 border=0 width="100%"><tr><td colspan=2 bgcolor=#A0A0A0 valign=top><table width="94%" border="0" cellspacing="0" cellpadding="0"><tr height=18 bgcolor=#A0A0A0><td class=lineRight id="td0" onmouseover="showMenuLayer('patients',td0);" onmouseout="disableMenuFlag();"><a 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- <td height=20 nowrap> <a href="javascript:history.back(1)"><img alt="Back to previous page" src=/vis/backarrow.gif width=28 height=8 border=0 align=absmiddle></a> <b>Patient Demographics</b></td>
- <td align=right nowrap>
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thisTable.style.visibility = "visible"; thisTable.style.display = "block"; thisTable.style.left = 59; if (currTable!=""&&currTable!=thisTable){ currTable.style.visibility = "hidden"; } currTable=thisTable;document.all['ma'].style.visibility = "visible";document.all['ma'].style.display = "block";document.all['ma'].style.left = 59;document.all['ma'].style.top = thisTable.style.top;document.all['ma'].style.width = thisTable.clientWidth;document.all['ma'].style.height = thisTable.clientHeight;}function hideLinkTable(){ hideLinkTableVal = true; linkTableTimer = setTimeout("killLinkTable()",200);}function killLinkTable(){ if(hideLinkTableVal == true && currTable!="") { currTable.style.visibility = "hidden"; currTable.style.display = "none"; }document.all['ma'].style.visibility = "hidden";document.all['ma'].style.display = "none";}function clearTimer(){ hideLinkTableVal = false; clearTimeout(linkTableTimer);}</script></table><BR>
- <script>
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- <B>Please update the patient details : </B> <font color="#FF0000">* indicates required fields.</font>
- <br><b style="color:red;">The highlighted items are key to meaningful use criteria. Please select them as applicable.</b><br>
- <Form name="AddEditForm" action="/servlet/PatientController?action=AddEditSubmit" Method="Post">
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- <legend><font class=heading><B>Name Change/Correction</B></legend>
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- <input type="radio" name="nameChangeEffect" value="new">Apply to records today onwards<BR>
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- </fieldset><BR><BR>
- </TD>
- </tr>
- <tr>
- <td width=140>First Name<font color="#FF0000">*</font></TD>
- <TD width=180><input tabIndex=5 type="TEXT" name="firstName" value="BERNADETTE" maxLength=35 size=25 onblur="javascript:changeCase(document.AddEditForm.firstName);checkNameChange(this.form)"></TD>
- <input type="hidden" name="firstNameOld" value="BERNADETTE">
- </tr>
- <tr>
- <TD>Last Name<font color="#FF0000">*</font></TD>
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- </tr>
- <tr>
- <TD>Middle Initial<span id="astrick2"></TD>
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- </tr>
- <tr>
- <TD nowrap>SSN<span id="astrick5"></TD>
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- </tr>
- <tr>
- <TD nowrap>Suffix</TD>
- <TD><input tabIndex=21 type="TEXT" size="11" maxlength="8" name="suffix" onblur="javascript:changeCase(document.AddEditForm.suffix)" value=""></TD>
- </tr>
- <tr>
- <TD nowrap>Father Name</TD>
- <TD><input tabIndex=22 type="TEXT" size="25" maxlength="32" name="fatherName" onblur="javascript:changeCase(document.AddEditForm.fatherName)" value=""></TD>
- </tr>
- <tr>
- <TD nowrap>Mother Name</TD>
- <TD><input tabIndex=23 type="TEXT" size="25" maxlength="32" name="motherName" onblur="javascript:changeCase(document.AddEditForm.motherName)" value=""></TD>
- </tr>
- <tr>
- <TD nowrap>Alias Name</TD>
- <TD><input tabIndex=24 type="TEXT" size="15" maxlength="32" name="aliasName" onblur="javascript:changeCase(document.AddEditForm.aliasName)" value=""></TD>
- </tr>
- <tr>
- <TD style="background-color: #B9B9B9">Date of Birth<font color="#FF0000">*</font></TD>
- <td><input type="text" name="dateOfBirth" value="" maxlength="10" size="10" tabIndex=25 onblur="chkItForDOB('dateOfBirth'),EnableDisableMuDemo(this)" onkeypress="maskItForDOB('dateOfBirth')" onmouseup="inputKey(this, event)" onkeyup="inputKey(this, event)"><img src=/vis/calIcon.gif align=absmiddle onclick='javascript:switchCal(document.AddEditForm.dateOfBirth)'> </td>
- </tr>
- <tr>
- <TD style="background-color: #B9B9B9">Gender<font color="#FF0000">*</font></TD>
- <TD><SELECT tabIndex=26 name="gender"><option value="">--- Select ---</option>
- <option value="Male">Male
- <option value="Female" SELECTED>Female</SELECT></TD>
- </tr>
- <tr>
- <TD>Guardian<span id="astrick1"></TD>
- <TD><input tabIndex=27 type="TEXT" name="guardian" onblur="javascript:changeCase(document.AddEditForm.guardian)" value="" size=25 maxLength="100"></TD>
- </tr>
- <tr>
- <TD>Work Status <span id="astrick3"></TD>
- <TD><SELECT tabIndex=35 name="workStatus">
- <option value="Full Time" SELECTED>Full Time
- <option value="Part Time">Part Time
- <option value="Unemployed">Unemployed
- <option value="Retired">Retired
- <option value="Preschooler">Preschooler
- <option value="Schooler">Schooler
- <option value="Self Employed">Self Employed
- <option value="Disabled">Disabled
- <option value="Unknown">Unknown</SELECT></TD>
- </tr>
- <tr>
- <TD>Occupation<span id="astrick4"></TD>
- <TD><input tabIndex=37 type="TEXT" name="occupation" onblur="javascript:changeCase(document.AddEditForm.occupation)" value="" maxLength="50" size=25></TD>
- </tr>
- <!-- added by shreyans for c4 module -->
- <!-------Added by Kumud on 14th March,08---------------->
- <TR> <TD>Employer<span id="astrickEmployer"></TD>
- <TD nowrap>
- <input readonly="readonly" tabIndex=53 id="b1" type="TEXT" name="employername" value="" maxlength="50" size=15>
- <input tabIndex=54 type=button style="width:80px" name="Employer By" value="Employer" onclick="javascript:selectEmployer('AddEditForm')">
- <input type="button" value="CLR" onclick="clearsEmployer()">
- </TD>
- </TR>
- <input type=hidden name=company value="">
- <!------------------------------------------->
- <!-- <tr>
- <TD>Employer</TD>
- <TD><input tabIndex=39 type="TEXT" name="company" value="" maxLength="50" size=25></TD>
- </tr>
- <tr valign=top>
- <TD>Employer Address</TD>
- <TD><TEXTAREA tabIndex=41 cols=28 rows=3 name="employerAddress"></TEXTAREA></TD>
- </tr> -->
- <!-------Added by Kishore on 2nd Nov,04---------------->
- <!-- <tr>
- <td>Attorney<span id="astrick6"></td>
- <td><input tabIndex=43 type=text name="attorney" value="" size=25></td>
- </tr> -->
- <!------------------------------------------->
- <TR> <TD>Attorney<span id="astrick6"></TD>
- <TD nowrap>
- <input tabIndex=53 readonly="readonly" type="TEXT" id="b2" name="attorney" value="" maxlength="50" size=15>
- <input tabIndex=54 type=button style="width:80px" name="Referred By" value="Attorney" onclick="javascript:selectAttorney('AddEditForm')">
- <input type="button" value="CLR" onclick="clears('b2')">
- </TD>
- </TR>
- <TR> <TD>Adjuster<span id="astrickAdjuster"></TD>
- <TD nowrap>
- <input tabIndex=153 readonly="readonly" type="TEXT" id="b7" name="adjuster" value="" maxlength="50" size=15>
- <input tabIndex=154 type=button style="width:80px" name="Referred1 By" value="Adjuster" onclick="javascript:selectAdjuster('AddEditForm')">
- <input type="button" value="CLR" onclick="removeAdjuster()">
- </TD>
- </TR>
- <tr>
- <TD>Student Status <span id="astrick7"></TD>
- <TD><SELECT tabIndex=45 name="studentStatus">
- <option value="Not a Student" SELECTED>Not a Student
- <option value="Full Time">Full Time
- <option value="Part Time">Part Time</SELECT></TD>
- </tr>
- <tr>
- <TD>Blood Group </TD>
- <TD><SELECT tabIndex=47 name="bloodType"><option value="">--- Select ---</option>
- <option value="A+">A+
- <option value="A-">A-
- <option value="B+">B+
- <option value="B-">B-
- <option value="AB+">AB+
- <option value="AB-">AB-
- <option value="O+">O+
- <option value="O-">O-</SELECT></TD>
- </tr>
- <TR>
- <TD style="background-color: #B9B9B9">Race <span id="astrickRace"></TD>
- <TD>
- <input tabIndex=48 type='text' name='racedescription' value='' size=25 readonly>
- <input type=button name=button value="Search" onClick="searchRace('PatientAddEdit');">
- </TD>
- </TR>
- <TR>
- <TD style="background-color: #B9B9B9">Ethnicity <span id="astrickEthnicity"></TD>
- <TD><SELECT tabIndex=49 name="ethnicity" onchange="javascript:EnableDisableMuDemo(this);">
- <option value="">----- Select -----</option>
- <option value="Andalusian">Andalusian</option>
- <option value="Argentinean">Argentinean</option>
- <option value="Asturian">Asturian</option>
- <option value="Belearic Islander">Belearic Islander</option>
- <option value="Bolivian">Bolivian</option>
- <option value="Canal Zone">Canal Zone</option>
- <option value="Canarian">Canarian</option>
- <option value="Castillian">Castillian</option>
- <option value="Catalonian">Catalonian</option>
- <option value="Central American">Central American</option>
- <option value="Central American Indian">Central American Indian</option>
- <option value="Chicano">Chicano</option>
- <option value="Chilean">Chilean</option>
- <option value="Colombian">Colombian</option>
- <option value="Costa Rican">Costa Rican</option>
- <option value="Criollo">Criollo</option>
- <option value="Cuban">Cuban</option>
- <option value="Dominican">Dominican</option>
- <option value="Ecuadorian">Ecuadorian</option>
- <option value="Gallego">Gallego</option>
- <option value="Guatemalan">Guatemalan</option>
- <option value="Hispanic or Latino">Hispanic or Latino</option>
- <option value="Honduran">Honduran</option>
- <option value="La Raza">La Raza</option>
- <option value="Latin American">Latin American</option>
- <option value="Mexican">Mexican</option>
- <option value="Mexican American">Mexican American</option>
- <option value="Mexican American Indian">Mexican American Indian</option>
- <option value="Mexicano">Mexicano</option>
- <option value="Nicaraguan">Nicaraguan</option>
- <option value="Not Hispanic or Latino">Not Hispanic or Latino</option>
- <option value="Panamanian">Panamanian</option>
- <option value="Paraguayan">Paraguayan</option>
- <option value="Peruvian">Peruvian</option>
- <option value="Puerto Rican">Puerto Rican</option>
- <option value="Salvadoran">Salvadoran</option>
- <option value="South American">South American</option>
- <option value="South American Indian">South American Indian</option>
- <option value="Spaniard">Spaniard</option>
- <option value="Spanish Basque">Spanish Basque</option>
- <option value="Uruguayan">Uruguayan</option>
- <option value="Valencian">Valencian</option>
- <option value="Venezuelan">Venezuelan</option>
- </SELECT>
- </TD>
- </TR>
- <!---<tr>
- <TD>Preferred Language</TD>
- <TD><SELECT tabIndex=50 name="temp1">
- <option>English
- <option>Spanish
- <option>French
- <option>Mandarin
- </SELECT></TD>
- </tr>
- <tr>
- <TD>Preferred Pharmacy</TD>
- <TD><SELECT tabIndex=51 name="temp2">
- <option>CVS
- <option>DrugStore
- <option>Kramer Pharmacy
- <option>LA Cross Pharmacy
- <option>WALGREENS
- <option>Wenbar Pharmacy Inc.
- </SELECT></TD>
- </tr>
- --->
- <tr class=hideprotal>
- <TD style="background-color: #B9B9B9">Smoker <span id="astrickSmoker"></TD>
- <TD><select name="smoker" onchange="javascript:EnableDisableMuDemo(this);"><option value="">--- Select ---</option>
- <option value="Current every day smoker">Current every day smoker
- <option value="Current some day smoker">Current some day smoker
- <option value="Former smoker">Former smoker
- <option value="Never smoked" SELECTED>Never smoked
- <option value="Smoker, current status unknown">Smoker, current status unknown
- <option value="Unknown if ever smoker">Unknown if ever smoker</select> </TD>
- </tr>
- <tr>
- <TD>Marital Status </TD>
- <TD><SELECT tabIndex=49 name="maritalStatus"><option value="">--- Select ---</option>
- <option value="Single" SELECTED>Single
- <option value="Married">Married
- <option value="Divorced">Divorced
- <option value="Legally Separated">Legally Separated
- <option value="Spouse Deceased">Spouse Deceased
- <option value="Partnered">Partnered</SELECT></TD>
- </tr>
- <tr class=hidePortal>
- <TD valign="top">Patient Type</TD>
- <TD><SELECT tabIndex=50 name="patientType"><option value="">--- Select ---</option>
- <option value="Deceased">Deceased
- <option value="Transferred">Transferred
- <option value="Moved">Moved
- <option value="Seen as consultation only">Seen as consultation only
- <option value="Other">Other</SELECT></td>
- </tr>
- <tr class=hidePortal>
- <td nowrap>Referring Physician<span id="astrick8"></td>
- <TD nowrap>
- <input tabIndex=53 id="b3" type="TEXT" name="referringDoctorName" value="" maxlength="50" size=15>
- <input tabIndex=54 type=button style="width:85px" name="Referred By" value="Referred By" onclick="javascript:selectRefDoctor('AddEditForm')">
- <input type="button" value="CLR" onclick="clears('b3')">
- </TD></tr>
- <tr class=hidePortal>
- <td nowrap>Other Ref. Physician</td>
- <TD nowrap>
- <input tabIndex=55 id="b4" type="TEXT" name="additionalReferredByDoctorName" value="" maxlength="50" size=15>
- <input tabIndex=56 type=button style="width:85px" name="Referred By" value="Referred By" onclick="javascript:selectAddnRefDoctor('AddEditForm')">
- <input type="button" value="CLR" onclick="clears('b4')">
- </TD></tr>
- <tr class=hidePortal>
- <TD nowrap>Primary Care Phy</TD>
- <TD><input tabIndex=57 id="b5" type="TEXT" name="primaryCarePhysician" value="" maxLength="50" size=15>
- <input tabIndex=58 type=button style="width:85px" name="PriCareLookup" value="Lookup" onclick="javascript:selectPriCareDoctor('AddEditForm')">
- <input type="button" value="CLR" onclick="clears('b5')">
- </TD></tr>
- <input tabIndex=59 id="b6" type="hidden" name="vnaName" value="">
- <!--<tr class=hidePortal>-->
- <!-- <td nowrap>VNA</td>-->
- <!-- <TD nowrap>-->
- <!--<input tabIndex=59 id="b6" type="TEXT" name="vnaName" value="" maxlength="50" size=15>-->
- <!--<input tabIndex=60 type=button style="width:85px" name="VNALookup" value="Lookup" onclick="javascript:selectVNA('AddEditForm')">-->
- <!--<input type="button" value="CLR" onclick="clears('b6')"> -->
- <!--</TD></tr>-->
- <TR class=hidePortal>
- <td>Principal Provider</td>
- <td><SELECT tabIndex=59 name="attendingDoctorId">
- <option value="">--- Select ---</option>
- <option value="3317A9F2-FE1D-4993-A496-CA969B5916B1" >Baptiste, Sylvia
- </option>
- <option value="E5E5D6F6-8DC5-47FE-8155-08336538A441" selected>Martin, Dean
- </option>
- <option value="AF5711F7-DB51-4739-BE05-A6BFD08DDB98" >Pile, Nadia
- </option>
- <option value="CCFB5DD5-CFD4-4BC1-AE82-4E8FD6E9CB8B" >Richardson, Rhan
- </option>
- <option value="A03CB969-EB47-4663-BA4D-60F695911B06" >Stedford, Audrey
- </option>
- </select>
- </td>
- </TR>
- <TR class=hidePortal>
- <TD>Visit Location</TD>
- <TD><Select tabIndex=60 Name=siteId style="width:160px">
- <option value="C7792C05-AA05-4D93-B029-959ABB26E955" SELECTED>Dean R Martin MD, FACOG, PC
- <option value="0EDE145E-41DC-4095-9547-7D2B799CB9DE">Antigua
- </select>
- </TD>
- </TR>
- <TR>
- <TD>OB Appt
- <input type="hidden" name="customLabels" id="customLabels1" value="CustomField1" />
- <input type="hidden" name="labelName" id="labelName1" value="OB Appt" />
- <input type="hidden" name="isCustomFieldMandatory" id="isCustomFieldMandatory1" value="0" />
- </TD>
- <TD>
- <input type="text" name="customFields" id="customFields1" value="" />
- </TD>
- </TR>
- <TR>
- <TD>Estimated Month of Delivery
- <input type="hidden" name="customLabels" id="customLabels2" value="CustomField2" />
- <input type="hidden" name="labelName" id="labelName2" value="Estimated Month of Delivery" />
- <input type="hidden" name="isCustomFieldMandatory" id="isCustomFieldMandatory2" value="0" />
- </TD>
- <TD>
- <select name="customFields" id="customFields2">
- <option value="">--- Select ---</option>
- <option value="Apr" >Apr</option>
- <option value="Augt" >Augt</option>
- <option value="Dec" >Dec</option>
- <option value="Feb" >Feb</option>
- <option value="Jan" >Jan</option>
- <option value="Jul" >Jul</option>
- <option value="Jun" >Jun</option>
- <option value="Mar" >Mar</option>
- <option value="May" >May</option>
- <option value="Nov" >Nov</option>
- <option value="Oct" >Oct</option>
- <option value="Sept" >Sept</option>
- </select>
- </TD>
- </TR>
- <input type="hidden" name="customFieldCount" value="2" />
- <!------------------------------------------->
- </table>
- </td>
- <td width=400>
- <TABLE width=400 cellpadding=0 cellspacing=1 border=0 style="margin-left:10px">
- <tr>
- <TD width=130>Address Line 1<font color="red">*</font></TD>
- <TD width=230><input tabIndex=62 type="TEXT" name="address1" onblur="javascript:changeCase(document.AddEditForm.address1)" value="9523 SEAVIEW COURT" maxLength=35 size=25></TD>
- </TR>
- <TR>
- <TD>Address Line 2</TD>
- <TD><input tabIndex=64 type="TEXT" name="address2" onblur="javascript:changeCase(document.AddEditForm.address2)" value="" maxLength=35 size=25></TD>
- </TR>
- <TR>
- <TD>City<font color="#FF0000">*</font></TD>
- <TD><input tabIndex=66 type="TEXT" name="city" onblur="javascript:changeCase(document.AddEditForm.city)" value="BROOKYLN" maxLength=35 size=25></TD>
- </TR>
- <TR>
- <TD>State<span id="astrick10"></TD>
- <TD><SELECT tabIndex=70 name="state"><option value="">--- Select ---</option>
- <option value="Alabama">Alabama
- <option value="Alaska">Alaska
- <option value="Am. Samoa">Am. Samoa
- <option value="Arizona">Arizona
- <option value="Arkansas">Arkansas
- <option value="California">California
- <option value="Colorado">Colorado
- <option value="Connecticut">Connecticut
- <option value="Delaware">Delaware
- <option value="District of Columbia">District of Columbia
- <option value="Florida">Florida
- <option value="Georgia">Georgia
- <option value="Guam">Guam
- <option value="Hawaii">Hawaii
- <option value="Idaho">Idaho
- <option value="Illinois">Illinois
- <option value="Indiana">Indiana
- <option value="Iowa">Iowa
- <option value="Kansas">Kansas
- <option value="Kentucky">Kentucky
- <option value="Louisiana">Louisiana
- <option value="Maine">Maine
- <option value="Maryland">Maryland
- <option value="Massachusetts">Massachusetts
- <option value="Michigan">Michigan
- <option value="Minnesota">Minnesota
- <option value="Mississippi">Mississippi
- <option value="Missouri">Missouri
- <option value="Montana">Montana
- <option value="Nebraska">Nebraska
- <option value="Nevada">Nevada
- <option value="New Hampshire">New Hampshire
- <option value="New Jersey">New Jersey
- <option value="New Mexico">New Mexico
- <option value="New York" SELECTED>New York
- <option value="North Carolina">North Carolina
- <option value="North Dakota">North Dakota
- <option value="Ohio">Ohio
- <option value="Oklahoma">Oklahoma
- <option value="Oregon">Oregon
- <option value="Pennsylvania">Pennsylvania
- <option value="Puerto Rico">Puerto Rico
- <option value="Rhode Island">Rhode Island
- <option value="South Carolina">South Carolina
- <option value="South Dakota">South Dakota
- <option value="Tennessee">Tennessee
- <option value="Texas">Texas
- <option value="Utah">Utah
- <option value="Vermont">Vermont
- <option value="Virgin Islands">Virgin Islands
- <option value="Virginia">Virginia
- <option value="Washington">Washington
- <option value="West Virginia">West Virginia
- <option value="Wisconsin">Wisconsin
- <option value="Wyoming">Wyoming
- <option value="APO - AA">APO - AA
- <option value="APO - AE">APO - AE
- <option value="APO - AP">APO - AP
- <option value="Other">Other</SELECT></TD>
- </TR>
- <TR>
- <TD>Zip Code<span id="astrick11"></TD>
- <TD><input tabIndex=74 type="TEXT" name="zipCode" value="11236" size=10 maxlength=10></TD>
- </TR>
- <TR>
- <TD>Country<span id="astrick12"></TD>
- <TD><SELECT tabIndex=78 name="country">
- <option value="USA" SELECTED>USA
- <option value="Canada">Canada
- <option value="Other">Other</SELECT></TD>
- </TR>
- <!-------Added by Indra on 9th Feb,05---------------->
- <TR>
- <TD>Preferred Phone</TD>
- <TD ><SELECT tabIndex=80 name="preferredPhoneNo" ONCHANGE="showDropDownBox()">
- <option value="">--Select--</option>
- <option value="HomePhone" >Home Phone</option>
- <option value="CellPhone" selected>Cell Phone</option>
- <option value="WorkPhone" >Work Phone</option>
- </SELECT></TD>
- </TR>
- <!-- added by manoj verma -->
- <TR>
- <TD>Call Preference</TD>
- <TD><SELECT tabIndex=81 name="callPreferenceOrder" >
- <option value="">--Select--</option><option value="DNC" >Do Not Call</option>
- <option value="C" SELECTED>Cell Only
- <option value="H">Home Only
- <option value="W">Work Only
- <option value="CH">Cell->Home
- <option value="CW">Cell->Work
- <option value="HC">Home->Cell
- <option value="HW">Home->Work
- <option value="WC">Work->Cell
- <option value="WH">Work->Home
- <option value="CHW">Cell->Home->Work
- <option value="CWH">Cell->Work->Home
- <option value="HCW">Home->Cell->Work
- <option value="HWC">Home->Work->Cell
- <option value="WCH">Work->Cell->Home
- <option value="WHC">Work->Home->Cell
- </SELECT>
- </TD></TR>
- <!------- end ---------------->
- <TR >
- <TD nowrap>Home Phone #<span id="astrick15"></TD>
- <TD><input tabIndex=82 type="TEXT" name="homePhone" onkeydown="maskPhone(event,this);" onkeyup="maskPhone(event,this);" value="718-763-2267" maxLength=12 size=25> ext <input type="text" maxlength="10" name="homePhoneExt" value="" size="5"></TD>
- </TR>
- <TR>
- <TD nowrap>Work Phone #<span id="astrick13"></TD>
- <TD><input tabIndex=84 type="TEXT" name="workPhone" onkeydown="maskPhone(event,this);" onkeyup="maskPhone(event,this);" value="" maxLength="12" size=25> ext <input type="text" maxlength="10" name="workPhoneExt" value="" size="5"></TD>
- </TR>
- <TR >
- <TD>Cell Phone #</TD>
- <TD><input tabIndex=86 type="TEXT" name="cellPhone" onkeydown="maskPhone(event,this);" onkeyup="maskPhone(event,this);" value="917-562-6963" maxLength="12" size=25></TD>
- </TR>
- <TR>
- <TD>E-mail Address<span id="astrickEmail"></TD>
- <TD><input tabIndex=88 type="TEXT" name="email" value="" maxLength="85" size=25></TD>
- </TR>
- <!-------Added by Indra on 9th Feb,05---------------->
- <TR>
- <TD nowrap>Driving License</TD>
- <TD><input tabIndex=102 type="TEXT" name="drivingLicense" value="" maxLength="50" size=25></TD>
- </TR>
- <TR>
- <TD nowrap>Significant Others</TD>
- <TD><input tabIndex=104 type="TEXT" name="significantOthers" onblur="javascript:changeCase(document.AddEditForm.significantOthers)" value="" maxLength="50" size=25></TD>
- </TR>
- <TR>
- <TD nowrap>Emergency Contact1 <span id="astrick14"></TD>
- <TD nowrap colspan=3><input tabIndex=106 size=25 type="TEXT" name="emergencyContact1" onblur="javascript:changeCase(document.AddEditForm.emergencyContact1)" value="BERNARD PORTER" maxLength="128"> Phone # <input tabIndex=106 size=25 type="TEXT" name="emergencyContactno1" value="646-641-6165" maxLength="128"></TD>
- </TR>
- <TR>
- <TD width=130 nowrap>Emergency Contact2 </TD>
- <TD colspan=3 nowrap><input tabIndex=109 size=25 type="TEXT" name="emergencyContact2" onblur="javascript:changeCase(document.AddEditForm.emergencyContact2)" value="" maxLength="128"> Phone # <input tabIndex=109 size=25 type="TEXT" name="emergencyContactno2" value="" maxLength="128"></TD>
- </TR>
- <tr class=hidePortal>
- <TD>Signature on File</TD>
- <td><input type="text" name="signatureOnFile" onblur="chkItForDate('signatureOnFile')" onkeypress="maskItForDOB('signatureOnFile')" onmouseup="inputKey(this, event)" onkeyup="inputKey(this, event)" maxlength="10" value="05/03/2011" size=10 tabIndex=110><img src=/vis/calIcon.gif align=absmiddle onclick='javascript:switchCal(document.AddEditForm.signatureOnFile)'>
- </td>
- </tr>
- <tr class=hidePortal>
- <TD>Release of Info Signed</TD>
- <td><input type="text" name="releaseOfInfoSigned" onblur="chkItForDate('releaseOfInfoSigned')" onkeypress="maskItForDOB('releaseOfInfoSigned')" onmouseup="inputKey(this, event)" onkeyup="inputKey(this, event)" maxlength="10" value="05/03/2011" size=10 tabIndex=111><img src=/vis/calIcon.gif align=absmiddle onclick='javascript:switchCal(document.AddEditForm.releaseOfInfoSigned)'>
- </td>
- </tr>
- <TR>
- <TD style="background-color: #B9B9B9">Preferred Language <span id="astrickPrimLan"></TD>
- <TD><SELECT tabIndex=49 name="preferredLanguage" onchange="javascript:EnableDisableMuDemo(this);"><option value="">--- Select ---</option>
- <option value="Arabic">Arabic</option>
- <option value="Armenian">Armenian</option>
- <option value="Chinese">Chinese</option>
- <option value="Dutch">Dutch</option>
- <option value="English">English</option>
- <option value="Finnish">Finnish</option>
- <option value="French">French</option>
- <option value="German">German</option>
- <option value="Greek">Greek</option>
- <option value="Gujarati">Gujarati</option>
- <option value="Hebrew">Hebrew</option>
- <option value="Hindi">Hindi</option>
- <option value="Iloko">Iloko</option>
- <option value="Irish">Irish</option>
- <option value="Italian">Italian</option>
- <option value="Japanese">Japanese</option>
- <option value="Korean">Korean</option>
- <option value="Persian">Persian</option>
- <option value="Polish">Polish</option>
- <option value="Portuguese">Portuguese</option>
- <option value="Russian">Russian</option>
- <option value="Spanish">Spanish</option>
- <option value="Tagalog">Tagalog</option>
- <option value="Vietnamese">Vietnamese</option>
- </SELECT>
- </TD>
- </TR>
- <tr class=hidePortal>
- <td>Pharmacy</td>
- <td>
- <select name=pharmacyId STYLE=" font-family:Courier;font-size:10pt">
- <option value=""></option>
- <option value="4106B1FF-BF60-4A92-9685-8297E494A204">
- 1 Stop Pharmacy 1220 Avenue P,Brooklyn,NY,11229,718-336-2244,718-234-2679
- <option value="AC4C2245-599B-44DF-AB50-30D60B1527C3">
- 1413 Rx Corp. DBA Quick Rx. 1413 Fulton Street,Brooklyn,NY,11216,718-638-5088,718-399-0236
- <option value="70B41C7B-FD51-4666-956D-4A2299D784DA">
- 16th ave pharmacy 4408 16th ave,Brooklyn,NY,11204,718-871-6700,718-871-3043
- <option value="979404D5-D9AB-4A03-8FFB-4E6FF31CDC16">
- 1746 PHARMACY CORP 524 CLARKSON AVE,Brooklyn,NY,11203,718-774-1656,718-774-5636
- <option value="659EF857-A58B-4A4D-A534-5EF7C90F2DE6">
- 18th Ave Pharmacy 5411 18th ave,Brooklyn,NY,11204,718-331-3600,718-331-3099
- <option value="CF46A215-C274-4263-8B76-6946EF5DB793">
- 424 Neiborhood Pharmacy, Inc. 424 Sutter Avenue,Brooklyn,NY,11212,718-485-6303,718-485-6303
- <option value="AD65FADA-01E8-42E3-9E2F-69C710CA100B">
- 5th Avenue Pharmacy Inc 4818 5th Ave,Brooklyn,NY,11220,718-439-8585,718-439-8567
- <option value="E5B11E1D-6D91-4D47-AB25-D49EE074ED50">
- 7 Star Pharmacy 596 Clarkson Avenue,Brooklyn,NY,11203,718-484-7213,718-484-2171
- <option value="7F974835-E0B7-4D79-99B2-62E24267DA32">
- 7th Avenue Chemists 5912 7th Avenue,Brooklyn,NY,11220,718-439-0998,718-439-0922
- <option value="0FA9CD22-B8A5-4315-9534-4C99179C8E69">
- 86th Street Community Pharma 2789 86th street,Brooklyn,NY,11223,718-266-2137,718-266-2137
- <option value="B91F1098-33F2-4D67-A873-A304EA63FCDA">
- 8th Avenue Drugs & Surgicals 4821 8th Avenue,Brooklyn,NY,11220,718-437-2800,718-437-3562
- <option value="67514E91-E6DC-4EBF-B9E6-3A3814952754">
- 8th Avenue Pharmacy, Inc. 5504 8th Avenue,Brooklyn,NY,11220,718-438-3838,718-438-3838
- <option value="38BDC69B-BC34-4138-8A71-A114F51EB9BF">
- A & G PHARMACY 1216 NEPTUNE AVE,Brooklyn,NY,11224,718-996-2277,718-996-2399
- <option value="90AF27E3-8D44-4B29-A641-D0162E11D79D">
- A & S Pharmacy 2201 Bath Avenue,Brooklyn,NY,11214,718-372-0797,718-372-0797
- <option value="DEBDD3ED-2F04-438F-B803-ACFE8D64D00B">
- A & W Pharmacy 1121 McDonald Ave,Brooklyn,NY,11230,718-377-8030,718-377-8593
- <option value="D4676C38-7D21-46D0-81EA-096DAD465371">
- A TO Z pharmacy 9407 5th Ave,Brooklyn,NY,11209,347-517-4040,347-497-5470
- <option value="0BB6C72C-8515-4489-B8B6-597CE1265693">
- A.M. PHARMACY INC 5702 8TH AVE,Brooklyn,NY,11220,718-238-9828,718-567-7569
- <option value="EA4677A6-2CCE-4BB1-8B2B-DF2D6337BD79">
- Aausadh Pharmacy 5th Ave and 46th Street,Brooklyn,NY,11220,718-972-2780,718-435-8081
- <option value="8D3B6821-D8DC-49FA-A77E-86DF17D9E231">
- ABC Drugs 1946 86th St,Brooklyn,NY,11214,718-234-2500,718-234-2679
- <option value="A1867303-22B3-49A4-903D-612E3632A46D">
- ABC Pharmacy, Inc. 371 McDonald Avenue,Brooklyn,NY,11218,718-853-7766,718-853-7007
- <option value="540F752E-5C62-4A89-86B6-466C699BC274">
- ABC Pharmacy, Inc. - Brooklyn 5015 8th Avenue,Brooklyn,NY,11220,718-686-8830,718-686-8870
- <option value="CA31ED73-5E00-4F9F-92D2-0DB33DF25F97">
- ABO PHARMACY & SURGICAL 8003 FLATLANDS AVE,Brooklyn,NY,11236,718-872-5142,718-872-5137
- <option value="C79A04F6-568F-4F8B-A3D7-72405B4408A9">
- AC Pharmacy 762 59th Street,Brooklyn,NY,11220,718-567-5318,718-567-3316
- <option value="96E63325-6AF9-4652-87A6-A174511A182F">
- ACE Pharmacy 235 Wyckoff Avenue,Brooklyn,NY,11237,718-418-3400,718-497-8231
- <option value="360D7BF1-FE00-4C97-B06D-F242F7640E8B">
- ADELPHI PHARMACY 3350 FULTON STREET,Brooklyn,NY,11208,718-827-9034,718-827-1414
- <option value="18D04237-8152-43BB-91E3-9330935E039F">
- Advantage Pharmacy 4910 Fort Hamiliton Pkwy,Brooklyn,NY,11219,718-437-4699,718-437-0796
- <option value="20E4A54E-AF09-4F86-9109-ADE9FECAB0D6">
- Aid Pharmacy 807 Kings Highway,Brooklyn,NY,11223,718-376-3313,718-376-3060
- <option value="D6E9061A-795E-4363-A3B2-FC0373C6CC48">
- AJ Care Pharmacy, Corp. 8011 8th Avenue,Brooklyn,NY,11214,718-331-2668,718-331-2886
- <option value="2DE06A45-4A55-422D-8D93-8A5548F0CAC4">
- AL-MEDINA PHARMACY, INC 1221 FLATBUSH AVE,Brooklyn,NY,11226,718-941-2669,718-941-0935
- <option value="508F0D22-030F-44A7-A0DC-1A288A94FAE1">
- Albany Pharmacy Inc. 178 Albany Avenye,Brooklyn,NY,11213,718-756-6061,718-404-0705
- <option value="0976C9F1-F1A4-4133-8A48-EA790B24B53E">
- Aldav Pharmacy 749 Ocean Pkwy,Brooklyn,NY,11230,718-724-2245,718-946-2453
- <option value="E199C310-3328-492D-8ED8-9445DF4FAA22">
- ALEXS PHARMACY INC 627 GRAVESEND NECK RD,Brooklyn,NY,11223,718-375-5020,347-462-2356
- <option value="25180E2C-C718-4C03-B158-0B450FBEFD99">
- All American Druggist 1101 BRIGHTON BEACH AVE.,Brooklyn,NY,11235,718-891-2801,718-743-5804
- <option value="D617BA35-9128-47FA-86B4-5C07752DCDAB">
- Alleon Pharmacy 6823 Ft Hamilton pkwy,Brooklyn,NY,11219,718-745-0733,718-921-3560
- <option value="D86AA98B-B236-454B-B94A-CB59664293C6">
- ALLEON PHARMACY 7133 5TH AVENUE,Brooklyn,NY,11209,718-748-1861,718-491-5527
- <option value="905BBF84-7D7E-4EAF-B188-8449C1E77C8D">
- Althealth Park Slope, LLC 1702 8th Ave Ste B,Brooklyn,NY,11215,718-788-2898,718-788-2703
- <option value="BF9BD0C4-54F6-4D36-B6BF-10EFF1EC4B53">
- AMERICAN PHARMACY 5524 8TH AVENUE,Brooklyn,NY,11220,718-686-1688,718-686-0322
- <option value="D7238E0B-DD59-4FAB-985D-3667A28B0C14">
- AMIABLE PHARMACY 1108 LIBERTY AVE,Brooklyn,NY,11208,718-827-7528,718-277-0193
- <option value="C9030A5D-EA74-4B14-AAD9-892D5D767F0F">
- An-Noor Pharmacy 35 101 Ave,Brooklyn,NY,11208,718-827-4000,718-827-4001
- <option value="7B9DF545-8AB3-4B00-8365-490ACBE4A3DD">
- ANTEKA PHARMACY 511 BRIGHTON BEACH AVE,Brooklyn,NY,11235,718-332-4002,718-676-1871
- <option value="245E0AD3-0DBF-40DC-BA84-6B67D264B4E9">
- Antelis Pharmacy 1502 Elm Avenue,Brooklyn,NY,11230,718-339-4483,718-336-8789
- <option value="E18FE0B1-E89A-4C4A-8050-77690F3976A5">
- Apple Drugs 376 Kingston Avenue,Brooklyn,NY,112134332,718-467-6700,718-467-2461
- <option value="B1546DB6-9896-4C86-B9DB-5E3EB68A530E">
- Apteka Pharmacy 937 Manhattan Ave,Brooklyn,NY,11222,718-389-4544,718-389-3313
- <option value="C19751AC-7A8D-4565-9311-0EED2E623D53">
- Ashland Pharmacy 123 Dekalb Avenue,Brooklyn,NY,11217,718-834-9884,718-834-9567
- <option value="1AAB63EF-5ABD-4656-B89F-D1B4A7934BA1">
- ATLANTIC PHARMACY 1706B ATLANTIC AVE,Brooklyn,NY,11213,718-221-2608,718-221-2972
- <option value="7329CAF8-3039-4038-BEBE-ACF13012E142">
- Avenue X Chemist 319 Avenue X,Brooklyn,NY,11223,718-375-3700,718-645-7544
- <option value="F60A3E86-15D9-4287-B812-9ACB7699B4C6">
- Avon Pharmacy 82 Graham Avenue,Brooklyn,NY,11206,718-384-0630,718-384-0699
- <option value="E9A0547E-F20A-4B51-BDBB-83A4EC1C413E">
- B M FAMILY PHARMACY 1388 FLATBUSH AVE,Brooklyn,NY,11210,718-859-0007,718-724-2609
- <option value="AA71C743-E4B7-45DE-9423-17E9549D050C">
- BALAJI PHARMACY, INC. 1708 MERMAID AVE,Brooklyn,NY,11224,718-996-9000,718-449-5106
- <option value="DF360EC8-6AB1-4D1C-A958-BD204F03A1FB">
- Ballard Pharmacy 226 Prospect Park West,Brooklyn,NY,11215,718-768-1325,718-832-3364
- <option value="03B3E6CE-0129-4A4B-A3E3-84DAD13ADF3D">
- Batish Drugs, Inc. 378 Lafayette Avenue,Brooklyn,NY,11238,718-623-8930,718-623-8914
- <option value="8CDF22A8-6EC7-41D3-8EF2-9DB8907DBDDF">
- Bay Care Pharmacy, LLC. 8506A Bay Parkway,Brooklyn,NY,11214,718-266-6160,718-266-6268
- <option value="9E66B47B-A534-4D5C-9035-A43DF93FB47E">
- Bay Pharmacy 1653 Sheepshead Bay Rd,Brooklyn,NY,11229,718-934-3838,718-648-9457
- <option value="D4FF8887-40AD-4199-914A-B5E84480F391">
- Bay Pharmacy 2240 86th Street,Brooklyn,NY,11214,718-373-2722,718-373-6852
- <option value="90C471D0-11B9-4AE2-9E19-947E0EE83B45">
- BAYRIDGE RX (SBSC LLC) 6910 3RD AVE,Brooklyn,NY,11209,718-680-2229,718-680-2232
- <option value="EEFF0DC8-99A2-4E14-BA89-6DA94AEE14CE">
- Bayridge Speciallty Phcy 7618 5th Ave,Brooklyn,NY,11209,718-745-6800,718-745-6850
- <option value="19C45D4D-EFA4-4C01-80EA-9CF33D8EDDD0">
- BEDSTUY PHARMACY 1458 FULTON STREET,Brooklyn,NY,11218,718-221-4860,718-221-4864
- <option value="DF3EBD4A-D0D8-4EF7-88C4-D47B9DFB3A84">
- Behrens Pharmacy, Inc. 231 Dekalb Avenue,Brooklyn,NY,11205,718-638-4350,718-622-4960
- <option value="8CD502E0-BB65-4172-A7A3-AEC1F7AFA868">
- BELL DRUGS 138 GRAHAM AVENUE,Brooklyn,NY,11206,718-388-4307,718-599-0935
- <option value="35B11FEB-5F73-4ED1-88D2-519899AEB1EA">
- Bello Pharmacy 179 St. Nicholas Ave,Brooklyn,NY,11237,718-456-1795,718-456-1795
- <option value="34ACD1D2-CFF5-47EE-823F-B626738D7102">
- Belmont Pharmacy 102 A Belmont Avenue,Brooklyn,NY,11212,718-485-3300,718-485-3301
- <option value="59158B3C-0CD9-41D9-95E3-3E8E82632F56">
- Berkeley Drugs 1951 Flatbush ave.,Brooklyn,NY,11234,718-338-3434,718-258-1768
- <option value="D03069B4-5EAA-4BDE-81BF-11A23C3D91A7">
- BESTCARE PHARMACY 8510 3RD AVE,Brooklyn,NY,11209,718-680-9855,718-680-9856
- <option value="7FB0D3D0-DAFD-459A-962A-01332F5E85D7">
- BETTER HEALTH PHARMACY 1147 FULTON STREET,Brooklyn,NY,11238,718-622-4743,718-638-9007
- <option value="681554D7-5F8B-4E57-B34C-013099F77BD1">
- Boardwalk Rx, Inc. 3100 Ocean Parway,Brooklyn,NY,11235,718-996-7600,718-996-7601
- <option value="12F8241F-F0A0-4FB4-AF3A-BD55A19874CB">
- Borbas Pharmacy, Inc. 2046 Bath Avenue,Brooklyn,NY,11214,718-677-9066,718-677-9065
- <option value="D39B9782-4236-48E8-84A7-FDBCA54D252B">
- Boreum Drugs, Corp. 194 Union Avenue,Brooklyn,NY,11211,718-387-8288,718-387-8288
- <option value="F5DE04A2-E346-42D0-B547-277719DE4DE5">
- BORINQUEN PHARMACY 106 GRAHAM AVE,Brooklyn,NY,11206,718-782-7539,718-782-7761
- <option value="DDBF0BD3-D859-4110-A778-5902D17AD073">
- BRIDGE APOTHECARY PHARMACY 104 Jay Street,Brooklyn,NY,11201,718-246-4100,718-246-2417
- <option value="92C12B19-5D82-4966-A439-579952C026A7">
- BRIDGE PHARMACY 8912 3RD AVENUE,Brooklyn,NY,11209,718-836-1400,718-836-1400
- <option value="7A41FE5A-1134-4482-9073-8EE26DB230FA">
- BRIGHTON 11th PHARMACY 124 Brighton 11th St.,Brooklyn,NY,11235,718-934-1360,718-934-1383
- <option value="38A282D0-BA06-42E8-80F2-5D0A4BF98437">
- Brighton Pharmacy 277 Brighton Beach Ave,Brooklyn,NY,11235,718-332-8428,718-332-6435
- <option value="D5D8A057-4625-4137-9F89-ECD05F72BDDA">
- Brook Medical Pharmacy 582 5th Ave,Brooklyn,NY,11215,718-499-2616,718-499-0400
- <option value="C390623A-9E31-4CAD-BEF5-85CF261652FD">
- Brookdale Pharmacy 2568 Linden Blvd,Brooklyn,NY,11208,718-485-0070,718-485-0188
- <option value="C3FF838D-182C-4FEC-9CEF-701E48822511">
- Brooklyn Center Pharmacy 104 Dekalb Avenue,Brooklyn,NY,11201,718-250-0060,718-852-0469
- <option value="5034BFFC-C8D2-4741-86CC-183B4B488E4E">
- Brooklyn Pharmacy, Inc. 1675 Flatbush Avenue,Brooklyn,NY,11210,347-462-4662,347-462-4664
- <option value="98462F13-23CE-458C-BDDA-7C1C2D490601">
- BROWNSVILLE PHARMACY 592 ROCKAWAY,Brooklyn,NY,11212,718-345-3399,718-345-2286
- <option value="B76FF6D0-1941-416B-AD3A-2DD6DDFE0330">
- BUFFALO DRUGS 183 BUFFALO AVE,Brooklyn,NY,11213,718-953-9083,718-953-9087
- <option value="A787FBFA-BC4C-4492-A3E5-379AC2023241">
- Burhan Pharmacy 715 Knickerbocker Ave,Brooklyn,NY,11221,718-381-7360,718-381-7360
- <option value="5CD76917-9504-4152-B311-40AFD4287AE8">
- Canarsie Plaza Pharmacy 8721 Flatsland Ave,Brooklyn,NY,11236,718-257-2344,718-257-2364
- <option value="16B94321-F477-42BF-9A48-E264165B8BBE">
- Care Max Pharmacy, Inc. 6721 Fort Hamilton Pkwy.,Brooklyn,NY,11219,718-833-6700,718-833-6701
- <option value="4C88E964-7680-4286-8375-CF40BDDA7D58">
- Care Pharmacy 5915 Ave. N,Brooklyn,NY,11234,718-209-2222,718-209-9489
- <option value="9427E579-9D3E-459D-BF77-49B84F0CA476">
- CARE PLUS PHARMACY 7010 18TH AVE,Brooklyn,NY,11204,718-256-4886,718-256-4877
- <option value="408E3612-B1E7-47E1-9065-7174EBBE61FE">
- Century Pharmacy 483 Kings Highway,Brooklyn,NY,11223,718-375-4100,718-375-4633
- <option value="BC6E4FD9-B6EC-4F40-95C7-8E8C5D85C157">
- CHURCH AVE PHARMACY 1810 Church Ave.,Brooklyn,NY,11226,718-941-2200,718-941-2300
- <option value="FDD6F541-8159-40FC-BDD6-03D8988C64A2">
- CITYLINE PHARMACY, CORP 511 CORTELYOU ROAD,Brooklyn,NY,11218,718-940-0310,718-940-0321
- <option value="22C1A0D6-CAFD-4E07-9090-70ACA7E15BD0">
- Clinton Apothecary 420 Clinton Street,Brooklyn,NY,11231,718-855-6171,718-852-9730
- <option value="67A1EE6A-28C2-4377-8B7D-529D3E6F2CC2">
- Community Care Pharmacy, Inc. 2913 Surf Avenue,Brooklyn,NY,11224,718-372-5300,718-372-5300
- <option value="40A90F1B-1D15-445E-A40A-CC0116DD3DA3">
- Compashion Pharmacy 5002 4th Avnue,Brooklyn,NY,11200,718-439-8383,718-439-5794
- <option value="E81C43E2-C0B9-4630-83F9-BDDDAA2401FE">
- Coney Island Pharmacy 2720 Mermaid Avenue,Brooklyn,NY,11224,718-333-2525,718-333-0955
- <option value="9B563F22-B576-46C2-962B-DE288D30C665">
- CORNER PHARMACY 166 DIVISION AVENUE,Brooklyn,NY,11211,718-599-2771,718-599-1474
- <option value="25208E74-BD1C-4C94-9164-C4C155BDC66D">
- Costco 976 3RD AVE 976 3RD AVE,Brooklyn,NY,11232,718-965-7616,718-965-8825
- <option value="D54511E2-E7C4-438E-8980-94B0673D3098">
- County Pharmacy 580 Nostrand Ave,Brooklyn,NY,11216,718-783-1143,718-783-1144
- <option value="FFEB04C4-68F8-4878-A345-FB35269F5910">
- Crest Pharmacy Ltd 196 Flatbush Ave,Brooklyn,NY,11217,718-933-8676,718-399-8684
- <option value="BC55D98D-0176-4395-97C3-23C6153E2C1F">
- Cropsey Pharmacy Inc. 2527 Cropsey Avenue,Brooklyn,NY,11214,718-449-0434,718-373-7061
- <option value="11B1D70C-5B7D-4FEB-9EDA-A7BEB013BB4D">
- CVS/Pharmacy 2472 Flatbush Avenue,Brooklyn,NY,11234,718-253-0200,718-338-5548
- <option value="A3D109CF-BF74-49ED-9E59-3F46E29048AF">
- CVS/Pharmacy 4901 Kings Highway,Brooklyn,NY,11234,718-252-3791,718-252-8208
- <option value="8A17AE5F-FF76-4EBE-AEF8-6061C0225089">
- CVS/pharmacy #0644 8430 NEW UTRECHT AVE.,Brooklyn,NY,11214,718-232-4204,718-234-4204
- <option value="84C3A09D-6CDF-4B05-851E-E5C226151309">
- CVS/pharmacy #0802 2320 RALPH AVENUE,Brooklyn,NY,11234,718-209-8125,718-209-8127
- <option value="8E8E00FD-612C-41C7-9459-C70209795DC4">
- CVS/pharmacy #0845 395 COURT STREET,Brooklyn,NY,11231,718-222-1583,718-222-1647
- <option value="193BE477-EB5D-44E4-94E7-3D0D90DD5EAE">
- CVS/pharmacy #1791 156 HENRY STREET,Brooklyn,NY,11201,718-237-5001,718-237-6997
- <option value="49646289-1236-49D4-9330-1F3E1143225A">
- CVS/pharmacy #2141 2925 KINGS HIGHWAY,Brooklyn,NY,11229,718-677-3875,718-677-7598
- <option value="3C7E751D-04C9-45B7-BE65-45CF7E809AA2">
- CVS/pharmacy #2344 1249 NOSTRAND AVENUE,Brooklyn,NY,11225,718-282-8908,718-282-8909
- <option value="D57F5664-C595-4CD7-82A8-95D17685D548">
- CVS/pharmacy #2410 6502-6510 18TH AVENUE,Brooklyn,NY,11204,718-331-3883,718-621-9044
- <option value="F1B5D7D0-616B-4406-9127-653B52D889AD">
- CVS/pharmacy #2428 512 NEPTUNE AVENUE,Brooklyn,NY,11224,718-996-0431,718-996-3651
- <option value="6B986966-9B8B-44D2-94C6-4ADC7912F90A">
- CVS/pharmacy #2431 2472 FLATBUSH AVENUE,Brooklyn,NY,11234,718-253-0474,718-338-5548
- <option value="F9B6B827-8029-4B19-9FDC-672032E733F1">
- CVS/pharmacy #2436 1346 PENNSYLVANIA AVENUE,Brooklyn,NY,11239,718-642-0544,718-642-0679
- <option value="955B2082-AAEA-4E7B-8A41-7203D58496B2">
- CVS/pharmacy #2441 2151 86TH STREET,Brooklyn,NY,11214,718-996-7904,718-996-3256
- <option value="0EB1BDEE-25EF-4A81-8A10-6D3EE95504F8">
- CVS/pharmacy #2443 2120 ROCKAWAY PARKWAY,Brooklyn,NY,11236,718-251-4158,718-251-6608
- <option value="40EC1F84-976D-40A5-92BD-79B5FCF487C6">
- CVS/pharmacy #2498 341 9TH STREET,Brooklyn,NY,11215,718-499-3546,718-499-9181
- <option value="E914766F-6880-4DCF-88A3-A611B01DF7E5">
- CVS/pharmacy #2574 6702 FT. HAMILTON PARKWAY,Brooklyn,NY,11219,718-238-8668,718-238-4734
- <option value="29DF048D-63DE-427C-AB8F-B0CBF1CDC314">
- CVS/pharmacy #2672 150 COURT STREET,Brooklyn,NY,11201,718-237-5886,718-237-4293
- <option value="6EF081DB-9CC1-4E8C-827C-16F70C238004">
- CVS/pharmacy #2699 411 DITMAS AVENUE,Brooklyn,NY,11218,718-435-8988,718-435-6428
- <option value="7FD39F0B-BD3A-4FC0-9E63-610F24EB040A">
- CVS/pharmacy #2700 1402 SHEEPSHEAD BAY ROAD,Brooklyn,NY,11235,718-332-8502,718-332-7167
- <option value="E837A85C-EA82-48F9-95F2-C92CCEBED975">
- CVS/pharmacy #2769 4901 KINGS HIGHWAY,Brooklyn,NY,11234,718-252-7170,718-252-8208
- <option value="F712899D-5E72-4D39-9FE3-F56CD7B8926E">
- CVS/pharmacy #2812 1070 FLATBUSH AVENUE,Brooklyn,NY,11226,718-282-5622,718-282-5517
- <option value="15E79374-0877-4C15-8C3D-5FDE1AE252BA">
- CVS/pharmacy #2906 10204 FLATLANDS AVE.,Brooklyn,NY,11236,718-257-4993,718-257-5110
- <option value="619ADA8F-4D4D-4F7B-AFFA-70E3140B5611">
- CVS/pharmacy #5134 2014 CROPSEY AVENUE,Brooklyn,NY,11214,718-266-9381,718-266-9382
- <option value="D7DD9325-0692-4B8E-B7DE-417DE9476108">
- Danish Pharmacy 443 Dekalb Ave,Brooklyn,NY,11205,718-622-0868,718-622-0289
- <option value="FD9B272C-013E-492E-86F7-0C8BD100CE8D">
- Dear Drugs 490 Ave,Brooklyn,NY,11223,718-375-4407,718-375-1282
- <option value="35553E20-2D66-4533-8A1A-C3DDB06B0BDB">
- Dekalb Drugs Inc 886 Dekalb Ave,Brooklyn,NY,11221,718-249-0670,718-249-0639
- <option value="500D51D7-DAB5-4811-A9DA-4CCC03D69CCE">
- DeKalb Pharmacy 1472 Dekalb Avenue,Brooklyn,NY,11237,718-381-0018,718-456-4983
- <option value="CA0A9E72-C025-482B-8C46-89D26F82D02A">
- Dermer Pharmacy 2064 Flatbush Ave,Brooklyn,NY,11234,718-377-4900,718-377-7853
- <option value="39C138EB-1126-4D4C-B0EF-83804C823942">
- DESHI PHARMACY INC. 191 BUFFALO AVE,Brooklyn,NY,11213,718-774-8702,718-493-3785
- <option value="65A628D8-5E47-4F8B-90FC-CC309C0AE680">
- Ditmas Pharmacy 509 Ditmas Ave,Brooklyn,NY,11218,718-675-0055,718-675-1274
- <option value="48494828-5A04-42A5-A582-D910589D1195">
- DIVISION PHARMACY 134 DIVISION AVENUE,Brooklyn,NY,11211,718-384-3589,718-486-7648
- <option value="14A74FC6-DC51-4D59-BDA9-B6C1E5C7AF8E">
- DM PHARMACY 525 EMPIRE BLVD,Brooklyn,NY,11225,718-221-6814,718-221-6815
- <option value="AA360D86-FB27-4319-9A89-9BA9F12424B2">
- DNG Pharmacy, Inc. 249 Graham Avenue,Brooklyn,NY,11206,718-384-6630,718-384-3331
- <option value="D285BD55-95AD-4B6B-9589-43651E38A8C9">
- DOLINSKY PHARMACY 1678 BATH AVE,Brooklyn,NY,11214,718-256-8423,718-256-2154
- <option value="F7306B2A-58F9-4C73-92D8-7E4B87D58737">
- Dr Martin 2035 Ralph,Brooklyn,NY,11234,718-9682642,7189682642
- <option value="1F677549-AF02-4EA7-9F47-5BE8D7E73A85">
- DRJ Drug Corp. 801 Church Ave,Brooklyn,NY,11218,718-438-2565,718-438-7019
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- Drug Mart Brooklyn 4914 new utrecht,Brooklyn,NY,11219,718-633-4900,718-435-0324
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- Drug Store (The) 5214 16th Ave,Brooklyn,NY,11204,718-436-1100,718-436-1206
- <option value="775D7853-FFEE-4FA5-B019-C98359592F9F">
- Drugs Care Pharmacy 1001 Church Avenue,Brooklyn,NY,11218,718-856-2976,718-856-2976
- <option value="3C836418-6F13-4C20-92B9-E7BE3033E0DB">
- DUANE READE #128 386 FULTON STREET,Brooklyn,NY,11201,718-330-0363,212-858-3577
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- DUANE READE #144 464 FULTON STREET,Brooklyn,NY,11201,718-643-9505,718-843-1383
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- DUANE READE #147 749 BROADWAY,Brooklyn,NY,11206,718-486-5688,718-486-6925
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- DUANE READE #154 44 COURT STREET,Brooklyn,NY,11201,718-852-1082,718-852-3714
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- DUANE READE #172 1181 LIBERTY AVENUE,Brooklyn,NY,11208,718-277-1580,718-235-1183
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- DUANE READE #178 1450 ROCKAWAY PARKWAY,Brooklyn,NY,11236,718-272-2504,212-272-2579
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- DUANE READE #183 1520 AVENUE J,Brooklyn,NY,11230,718-253-8080,718-253-7580
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- DUANE READE #211 4318 13TH AVENUE,Brooklyn,NY,11219,718-686-0047,718-686-0166
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- DUANE READE #219 3090 OCEAN AVENUE,Brooklyn,NY,11235,718-368-4291,718-368-4296
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- DUANE READE #277 1517 CORTELYOU RD,Brooklyn,NY,11226,718-287-9078,718-287-9176
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- DUANE READE #285 101-105 BRIGHTON BEACH AVE,Brooklyn,NY,11209,718-449-9188,718-449-9214
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- DUANE READE #286 1833 NOSTRAND AVE,Brooklyn,NY,11226,718-693-3059,718-693-7813
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- DUANE READE #294 2141-45 NOSTRAND AVE,Brooklyn,NY,11210,718-434-1211,718-859-6751
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- DUANE READE #298 16 COURT STREET,Brooklyn,NY,11201,718-855-3980,718-522-0991
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- DUANE READE #301 518-520 KINGS HWY,Brooklyn,NY,11223,718-375-8911,718-375-7428
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- DUANE READE #305 1 REMSEN AVENUE,Brooklyn,NY,11201,718-953-5084,718-778-5841
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- DUANE READE #312 300-B FLATBUSH AVE,Brooklyn,NY,11217,718-399-2716,718-399-3225
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- DUANE READE #316 1110 KINGS HWY,Brooklyn,NY,11229,718-375-5700,718-375-5708
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- DUANE READE #349 750 NEW YORK AVE,Brooklyn,NY,11203,718-941-8694,718-941-6549
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- DUANE READE #367 5423 SECOND AVE,Brooklyn,NY,11220,718-439-4879,718-492-2824
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- DUANE READE #373 247 HERKIMER STREET,Brooklyn,NY,11216,718-623-0332,718-636-8775
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- DUANE READE #376 4721 16THE AVENUE,Brooklyn,NY,11204,718-438-1800,718-853-6563
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- DUANE READE #407 3131 KINGS HIGHWAY,Brooklyn,NY,11234,718-338-2385,718-338-9215
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- DUANE READE #410 756 MYRTLE AVE,Brooklyn,NY,11206,718-237-4526,718-237-0348
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- DUANE READE #419 893 MANHATTAN AVE,Brooklyn,NY,11222,718-389-6440,718-389-0588
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- DUANE READE #429 164 KENT AVE,Brooklyn,NY,11211,718-302-1549,718-302-0121
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- DUANE READE #432 5008 5TH AVE,Brooklyn,NY,11220,718-439-0614,718-439-4630
- <option value="D8747872-A60E-4921-81AF-0F7AEF86754D">
- DUANE READE #444 2265 RALPH AVENUE,Brooklyn,NY,11234,718-241-3700,718-241-6695
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- DUANE READE #464 436 86TH STREET,Brooklyn,NY,11209,718-833-7758,718-833-5093
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- DUANE READE #474 2931 AVENUE U,Brooklyn,NY,11229,718-648-8308,718-648-8191
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- DUANE READE #482 1401 KINGS HWY,Brooklyn,NY,11229,718-627-9199,718-627-9356
- <option value="B1450038-4372-4096-9C01-7E15A7334096">
- DUMONT PHARMACY 364 JUNIUS STREET,Brooklyn,NY,11212,718-485-4012,718-485-5012
- <option value="FAB81FFD-29F7-459A-AC01-7CEBAE2078AC">
- Echo Bridge Pharmacy 260 Broadway,Brooklyn,NY,11211,718-782-3030,718-782-2626
- <option value="1E182BE4-5F38-4789-B043-B217645401B1">
- Eisenberg Pharmacy 203 Brighton Beach Avenue,Brooklyn,NY,11235,718-743-1200,718-743-1029
- <option value="04673531-0E10-4387-AA93-0238E0476C1B">
- ELIYAHUS PHARMACY, INC. 573 Kings Hwy,Brooklyn,NY,11223,718-627-0485,718-627-2757
- <option value="EF910EA0-73C1-4B27-BC62-71B5C8825B7E">
- Ellery Street Pharmacy Inc. 304 Ellery Street,Brooklyn,NY,11206,718-782-9345,718-782-3839
- <option value="E141F6D9-AECA-4FEA-8316-3C30D87DBCF2">
- Elm Pharmacy 1651 CONEY ISLAND AVENUE,Brooklyn,NY,11230,718-336-8300,718-336-8421
- <option value="4C898A7F-C369-4190-BC24-657076DFD2EE">
- Emcon Pharmacy 49 5th Ave,Brooklyn,NY,11217,718-789-3370,718-789-1490
- <option value="F8D31732-7FF5-48D7-B3C1-1CA79595DC3E">
- Empire Pharmacy 1864 86th. Street,Brooklyn,NY,11214,718-234-7272,718-234-2360
- <option value="24728545-99CB-46CC-A2D6-F2FA90D73328">
- Empire Pharmacy, Inc. 353 Empire Blvd.,Brooklyn,NY,11225,718-467-0918,718-774-3078
- <option value="242AF716-4B05-4D39-8D44-21400EBA7E81">
- Estis Pharmacy 300 TROY AVE,Brooklyn,NY,11213,718-484-4305,718-484-4306
- <option value="D3D7FC97-5BC6-4DC3-9F2B-7418BFDBD207">
- Euro Chemists 669 Manhattan Avenue,Brooklyn,NY,11222,718-349-6696,718-349-6697
- <option value="BAC29505-CD2B-4EC9-8337-F346C262C08D">
- Evans Drug Store 878 Norstrand Ave,Brooklyn,NY,11225,718-771-7271,718-953-5626
- <option value="C2064247-C31F-4418-8A7D-38D697E39A17">
- EXCEL DRUG 42 THOMAS S BOYLAND ST,Brooklyn,NY,11233,718-453-1003,718-453-6121
- <option value="B05015E0-59CD-47BE-A9F5-2CD7AC06BC9F">
- Express Drug Store 1420 Avenue J,Brooklyn,NY,11230,718-677-5800,718-677-0708
- <option value="D68822C5-C76C-4A8C-A197-941AC89C0E0F">
- FAMILY DRUG STORE 3010 Mermaid Ave,Brooklyn,NY,11224,718-373-2300,718-373-2230
- <option value="0C000EB8-A674-4122-8013-0854702AAF50">
- Family Drugstore 3692 NOSTRAND AVE,Brooklyn,NY,11229,718-769-9600,718-769-9630
- <option value="FA7FA4FE-985B-4D2C-A0E8-3EB80B4EBC93">
- Family First Pharmacy 4507 8th Ave,Brooklyn,NY,11220,718-633-8388,718-633-8488
- <option value="4BE70F6B-1C50-4A77-BFA9-43FE933AE3F1">
- Family Health Pharmacy 8510 18th Avenue,Brooklyn,NY,11214,718-837-5777,718-837-5779
- <option value="358764EB-3317-4EA1-B1AE-584847B16F88">
- FAMILY PHARMACY 1401 Avenue U Brooklyn,Brooklyn,NY,11229,718-356-6813,718-382-1195
- <option value="BA0DA390-1A24-4566-9CA5-A60876D2E6E5">
- FAMILY PHARMACY 436 ROCKAWAY AVENUE,Brooklyn,NY,11212,718-342-7368,718-342-7546
- <option value="C813445A-8978-4C65-9540-9A23EA70FC8F">
- Family Pharmacy 2823 Nostrand Pharmacy,Brooklyn,NY,11229,718-252-2818,718-252-4611
- <option value="32624C37-05FB-4903-8300-5CA13510EE25">
- Family Pharmacy, Inc. 1101 Flatbush Avenue,Brooklyn,NY,11226,718-703-2440,718-703-2445
- <option value="2F1B4C30-5E2C-4D94-9F46-4B4283F4AEFC">
- Farmacia Mejor, Inc. 90 Bushwick Avenue,Brooklyn,NY,11211,718-387-0939,718-387-6022
- <option value="049B2FD1-DFB7-49A1-A1F7-E0881C64FBA6">
- Farmacon Pharmacy 8007 5th Ave,Brooklyn,NY,11209,718-238-1090,718-748-9275
- <option value="0749EE82-6589-44FD-A8BB-A1EC1578B1E5">
- FIne Care Pharmacy 4723 13th Ave.,Brooklyn,NY,11219,718-438-6555,718-438-7353
- <option value="1BCDA3FC-7B33-4586-A999-020C3B74DE78">
- Fine Care Pharmacy 1490 Flatbush Ave,Brooklyn,NY,11210,718-421-8161,718-421-8160
- <option value="E2D66D7D-51C8-4678-8FB6-80B7D8EDCF87">
- Fine Care Pharmacy 1611 Broadway,Brooklyn,NY,11211,718-942-4842,718-942-4840
- <option value="15ED4C4A-3AAB-4836-B230-BA8080756C9A">
- Fine Care Pharmacy, Inc. 981 Fulton Street,Brooklyn,NY,11238,718-857-3499,718-857-3498
- <option value="9F23CC94-A5B1-4B01-B158-F892BD3C9F44">
- First Care Pharmacy 902 Foster Ave,Brooklyn,NY,11230,718-859-4100,718-859-0033
- <option value="B7DA6CB2-E455-4588-B449-DCD31247922F">
- First Choice Pharmacy 5912 8th Ave,Brooklyn,NY,11220,718-439-8077,718-439-8096
- <option value="2E9D8753-4F00-48B6-8EC8-9AEBDD29479F">
- Flatbush Express Pharmacy, I 860 Flatbush Ave,Brooklyn,NY,11226,718-282-4777,718-282-2776
- <option value="50C4165A-7BE9-4F66-833F-C88139AD8C7D">
- FLATBUSH PHARMACY 21 34 BEVERLY ROAD,Brooklyn,NY,11226,718-284-0909,718-284-1250
- <option value="D65AE059-A24A-4D97-8F17-C3DF35D3586F">
- Flushing ave pharmacy 414 flushing ave,Brooklyn,NY,11205,718-260-8999,718-260-8999
- <option value="04F44F7D-921E-42CC-AF46-D71F5FABA45C">
- Foster Maaz Pharmacy, Inc. 1056 Coney Island Avenue,Brooklyn,NY,11230,718-421-5533,718-421-7440
- <option value="BF5513F9-9A2E-4E89-BBB2-A0FA4FE44C5D">
- Franklin & Carroll Drugs, Inc 886 Franklin Avenue,Brooklyn,NY,11225,718-221-1838,718-221-1832
- <option value="EFD917DB-5100-4899-AA85-A5C93B5AC32D">
- Fulton Drugs, Inc 1548 Fulton Street,Brooklyn,NY,11216,718-735-3784,718-735-6019
- <option value="21D4AFD9-AAE8-4078-B114-92DF19F9C2C9">
- Fulton Family Pharmacy Inc. 668-B Fulton St.,Brooklyn,NY,11217,718-858-8990,718-858-7990
- <option value="BDACB1C8-5B63-423E-BA1D-FD38CBBB1A1E">
- Fulton Pharmacy 2818 Fulton Street,Brooklyn,NY,11207,718-235-6394,718-874-3903
- <option value="BC87B5E4-71C8-45EF-BFFF-DF90094F852E">
- Fusion Pharmacy, Inc. 2276 65th Street,Brooklyn,NY,11204,718-975-2131,718-975-2133
- <option value="02BAB190-AD79-42B5-84AF-134A193FCD65">
- Gates & Garvey Pharmacy, Inc. 276-280 Marcus Garvey Blvd.,Brooklyn,NY,11221,718-443-8787,718-443-6660
- <option value="8B44E09B-5117-4BF4-BBD5-AA5B1E8F0F42">
- Geo Pharmacy, Inc. 685 Coney Island Avenue,Brooklyn,NY,11218,718-703-1888,718-703-1889
- <option value="D6495B45-D33D-459F-A2E2-CA911AF0675F">
- Getwell Pharmacy, Inc. 5218 8th Avenue,Brooklyn,NY,11220,718-686-0512,718-686-0811
- <option value="7973B860-719B-4A68-B9E6-6F89F873F804">
- GLOBAL CARE PHARMACY, INC. 5905 8TH AVENUE,Brooklyn,NY,11220,718-851-8998,718-851-8997
- <option value="2148B249-DD28-4431-A0F2-54535CCE48BE">
- Globe Drug Store 405 86th Street,Brooklyn,NY,11209,718-745-2233,718-745-1424
- <option value="7837D95A-6914-44B2-9DCC-59231DC834FE">
- Gold Street Phamracy 111 Gold Street,Brooklyn,NY,11201,718-855-1990,718-720-5286
- <option value="8A212692-818D-421D-8B81-75D7264B928C">
- Good Day Pharmacy, LLC. 1642 Bath Ave,Brooklyn,NY,11214,718-236-8828,718-236-8829
- <option value="1F13A50B-BBC8-4153-883B-0BC3998A4321">
- Good Neighbor Pharmacy 1614 Avenue M,Brooklyn,NY,11230,718-375-8900,718-375-0478
- <option value="9B30B864-55F5-43E5-8762-434C59B87B31">
- Goodhealth Pharmacy 310 KINGS HIGHWAY,Brooklyn,NY,11223,718-382-9999,718-998-2427
- <option value="1D39505F-7EE1-427C-A1ED-6AA2A3E05D8C">
- GRAND BUY PHARMACY 47-17 8TH AVE,Brooklyn,NY,11220,718-853-2845,718-853-2846
- <option value="8D5DA380-76AF-4D29-BB98-C9D485099C02">
- Greene Pharmacy 702 Fulton Street,Brooklyn,NY,11217,718-834-6368,718-330-2503
- <option value="44C46344-A944-4748-BE36-7B32F36BB747">
- Greenfield Pharmacy 1526 Courtelyo Road,Brooklyn,NY,11226,718-282-7660,718-282-5152
- <option value="34282D97-E6B0-4742-9720-9850D1768E83">
- Gristedes Pharmacy 544 101 Clark St,Brooklyn,NY,11201,718-834-9003,718-246-0081
- <option value="1EA57F81-9F18-499E-B2E3-00587B6F6D2F">
- GS Pharmacy LLC 1932 Nostrand Ave,Brooklyn,NY,11210,718-421-4068,718-421-4085
- <option value="D42FCF66-2350-40E5-9CFB-0F4A766E2C63">
- GST Pharmacy 669 Grand Street,Brooklyn,NY,11211,718-963-1018,718-963-2635
- <option value="BC231F9B-EF11-4402-B558-3974593D1240">
- GULSHAN PHARMACY 509 RALPH AVENUE,Brooklyn,NY,11223,718-493-0288,718-856-5029
- <option value="B719D71D-4CAF-414D-B8A5-E6C94547A9C6">
- Hamiliton Drugs 4514 Fort Hamilton Parkway,Brooklyn,NY,11219,718-435-8800,718-435-7624
- <option value="8EA1EF87-32D7-4C33-B1D7-F1F89FEE18A2">
- HAROLDS PHARMACY 2272 MCDONALD AVENUE,Brooklyn,NY,11223,718-996-4200,718-449-0288
- <option value="EBBA139B-2510-4DCC-8B92-9226669C6757">
- Harrico Church Pharmacy 3016 Church Avenue,Brooklyn,NY,11226,718-282-4615,718-282-3840
- <option value="E7EB8864-C9DC-4FFE-84BD-2F23A8AC4287">
- HARRICO KNICKERBOCKER DRUG. 394 KNICKERBOCKER AVE,Brooklyn,NY,11237,718-452-5521,718-452-2368
- <option value="CD3A5C56-FFAE-44CB-AADF-C517A7170BE2">
- Harrico Pharmacy 1409 Coney Island Ave,Brooklyn,NY,11230,718-377-7724,718-377-1675
- <option value="80B7B903-0600-4BF3-808F-19D9CD1F8FF0">
- Health Aid Pharmacy 291 7th Ave,Brooklyn,NY,11215,718-499-4610,718-499-4693
- <option value="3EE218BF-9A2B-4EA3-B108-E13E13F60432">
- Health Link Pharmacy 5523 7th Avenue,Brooklyn,NY,11220,718-686-8388,718-686-8822
- <option value="4387D955-7752-4A49-B0F1-4BC46C10173F">
- Health Net Pharmacy, Inc 3601 Church Ave,Brooklyn,NY,11203,347-533-8020,347-533-8021
- <option value="89B81D6E-30A0-4853-952E-01C0DFE21C9D">
- Health Plus Pharmacy 6605 Bay Parkway,Brooklyn,NY,11204,718-232-0810,718-232-0892
- <option value="9BF30403-FAD9-4FD5-BFFD-2049FFBB55F9">
- Health Point Drugs, Inc 392 Murtle Ave,Brooklyn,NY,11205,718-855-5958,718-802-1989
- <option value="051709AD-71E5-4DEA-9D8A-EC09B8794A6A">
- HEALTH STAR PHARMACY 1422 AVE U # 3,Brooklyn,NY,11229,718-645-1227,718-645-7454
- <option value="09311866-0138-4A04-ACEE-216192C99713">
- Health Treasures Pharmacy 8512 20th Avenue,Brooklyn,NY,11214,718-333-0395,718-333-0389
- <option value="06B6D306-1E34-435D-9D44-92A2E749D5F3">
- HEALTHCARE PHARMACY 2402 MERMAID AVENUE,Brooklyn,NY,11224,718-996-9900,718-996-9922
- <option value="157F1386-B2C8-4E74-A9D1-6AFDE9564BD0">
- HEALTHMAX PHARMACY 5313 5th Ave,Brooklyn,NY,11220,718-567-8000,718-765-9056
- <option value="86CFA7D9-66B1-4F4B-B615-DD2AB1157F04">
- Healthone Pharmacy, Inc. 119 Pennsylvania Avenue,Brooklyn,NY,11207,718-495-9015,718-282-8291
- <option value="7B10BD02-9BF1-403B-BD5C-D2D6F7F5913E">
- Heights Apothecary Pharmacy 79 Atlantic Avenue,Brooklyn,NY,11201,718-522-2588,718-522-2388
- <option value="DB15804E-1419-45F2-82D6-DB0EDDAA3FE6">
- HINA DRUGS 4 SUTTER AVNENUE,Brooklyn,NY,11212,718-778-3900,718-778-3379
- <option value="BF297CF4-0145-41E9-9FD0-8C3183E40045">
- HIP Pharmacy: Bedford Willia 233 Nostrand Avenue,Brooklyn,NY,11205,718-826-5960,718-826-5945
- <option value="0E8365C4-7E17-43B5-8B51-2B5F0D29517D">
- Hoyt Pharmacy 3024 Atlantic Avenue,Brooklyn,NY,11208,718-277-9160,718-277-9164
- <option value="75688A83-A420-4CB8-948B-6658C5FC8250">
- Humdard Pharmacy & Food Mart 949 Coney Island Avenue,Brooklyn,NY,11230,718-703-1800,718-703-7787
- <option value="98042583-9B48-41CC-B985-0ACAD6B3B6AB">
- Hyat Drugs, Inc. 1214 Liberty Avenue,Brooklyn,NY,11208,718-827-7700,718-827-7701
- <option value="F6615BD5-6BB9-4FC6-ACDF-03E8C4B4F581">
- Ideal Pharmacy 5409 5th Ave,Brooklyn,NY,11220,718-439-5900,718-439-3697
- <option value="2EC73EFA-13E6-43E3-A88D-9D720422DD8A">
- Image Prescription Center 119 Church Ave,Brooklyn,NY,11218,718-686-7343,718-686-7492
- <option value="B737AEE6-AAA3-4CCF-9AEA-63FB603076B3">
- IMAGES PHARMACY, INC. 1383 BUSHWICK AVENUE,Brooklyn,NY,11207,718-455-5065,718-455-9398
- <option value="FB04A7F3-EA26-4B43-A6B7-0D584E63F968">
- Interboro Pharmacy 75 Nevins Street,Brooklyn,NY,11217,718-858-5500,718-858-5506
- <option value="F705BF82-6297-4B70-9ABC-6E1504AAB8DC">
- Irving Pharmacy 115 Irving Ave,Brooklyn,NY,11237,718-484-8510,718-484-8508
- <option value="427B9772-B643-4ECE-A048-7C9713C16629">
- IW Pharmacy, Inc. 804 54 Street,Brooklyn,NY,11220,718-633-2988,718-633-6388
- <option value="086F0BC8-1735-4AD3-A6DD-8FBF7DC91782">
- J & A Drugs (Krimko Pharmacy) 954 Nostrand Ave,Brooklyn,NY,112253001,718-467-1111,718-467-4150
- <option value="8CA49F5E-9F50-4411-8068-9DA87006D2A2">
- J & L Pharmacy Corp. 8513 Bay 16th Street,Brooklyn,NY,11214,718-232-5541,718-232-5540
- <option value="96C43E5F-7449-435D-BEA8-3B9D8B87A762">
- J Drugs 1205 AVENUE J,Brooklyn,NY,11230,718-258-6686,718-258-2360
- <option value="B7378934-8CA7-4932-AE65-FF335E3CA322">
- J Drugs II/Kings Highway Che 3402 Avenue N,Brooklyn,NY,11234,718-258-5858,718-258-2600
- <option value="8AB506BF-3982-48CB-AF38-2A84689E8004">
- J&R Pharmacy, Inc. 2302 Mermaid Avenue,Brooklyn,NY,11224,718-266-6286,718-266-6386
- <option value="9B0B014C-B6F3-43D3-9748-1990A05CCC48">
- Jacoffs Pharmacy 839 Empire Blvd,Brooklyn,NY,11213,718-774-7373,718-467-0741
- <option value="57A1C8B9-6A83-49D4-A112-60D377571C65">
- Janus Pharmacy, Inc. 833 58th Street,Brooklyn,NY,11220,718-854-7092,718-854-1786
- <option value="703B2A17-8274-4502-BA77-F6B8340912BB">
- JNJ Pharmacy 761 61st Street,Brooklyn,NY,11220,718-492-8889,718-492-3883
- <option value="96F60056-3D70-4848-B23E-3A0F4F4D89ED">
- JUNCTION PHARMACY 2109 NOSTRAND AVE,Brooklyn,NY,11210,718-421-3600,718-434-4341
- <option value="DD631D22-7AFF-4B6B-B32A-0F3B3A5518AE">
- Just in Time Pharmacy II 96 Moore Street,Brooklyn,NY,11206,718-218-6630,718-218-8046
- <option value="2D12D213-2593-406E-B77C-66931505F735">
- KALA PHARMACY 9311 CHURCH AVE,Brooklyn,NY,11212,718-495-3901,718-385-5252
- <option value="6DCA6623-0BA0-4BEA-A580-80BD5DA7EB35">
- KATZ DRUGS 76 GRAHAM AVE,Brooklyn,NY,11206,718-388-4588,718-388-4588
- <option value="17EB6206-B184-4392-958F-C412BEC4448B">
- KELLYS PHARMACY 5825 5th AVE,Brooklyn,NY,11220,718-439-6360,718-492-1234
- <option value="E30C93BC-702B-4E56-8A96-EDF5CE07640D">
- Kids RX Brooklyn 189 7th Ave.,Brooklyn,NY,11215,718-369-6100,718-369-6101
- <option value="EEB1E30D-30C5-4791-8C1E-BA1C750E2DB1">
- KINETIC PHARMACY 6009 8TH AVE,Brooklyn,NY,11220,718-686-7288,718-686-0258
- <option value="9EB5BF23-36C4-4E41-93E1-4678AA1F2A7F">
- Kings Bay Chemists 3610 Nostrand Ave.,Brooklyn,NY,11229,718-891-9300,718-891-9378
- <option value="DE74EBB8-88F5-4D35-9A9A-33A617556FE3">
- KINGS CARE PHARMACY INC. 433 KINGS HIGHWAY,Brooklyn,NY,11223,718-336-3355,718-336-3354
- <option value="3CD9514A-1B97-494D-9B2D-933BFBF3A361">
- KINGS COURT DRUGS, INC. 610 EAST 16 STREET,Brooklyn,NY,11226,718-434-6565,718-434-3699
- <option value="7AF4CAC1-B5F7-4E11-ADF1-54C47382D2D0">
- Kings Drug and Surgical 492 Clarkson Ave,Brooklyn,NY,11203,718-363-3300,718-363-2949
- <option value="FAEDC85B-3E54-4A76-9693-B32FE5E81F48">
- Kings Highway Pharmacy 1671 East 13th Street,Brooklyn,NY,11229,718-375-5757,718-375-0364
- <option value="3BEBE271-7080-4D4B-8A6F-92FE2215E4F6">
- Kings Park Slope 357 Flatbush Ave,Brooklyn,NY,11238,718-230-3535,718-230-0596
- <option value="80F9BB50-FAF1-4F24-9A10-212F642C9CEB">
- Kings Thriftway 1909 Kings Highway,Brooklyn,NY,11229,718-339-3500,718-998-2280
- <option value="4C680D14-4ADC-4147-BA69-030270453860">
- Kingsboro Pharmacy 868 Dekalb Ave,Brooklyn,NY,11221,718-443-6000,718-874-3638
- <option value="890DFBA6-E4FB-4D8A-930A-0034E4827739">
- KINGSWAY PHARMACY 1425 KINGS HWY,Brooklyn,NY,11229,718-382-7700,718-645-8655
- <option value="6DDABAFB-0D15-4E43-9D45-40A8AF80B2B9">
- KLEINS PHARMACY 4818 13TH AVE,Brooklyn,NY,11219,718-633-1548,718-633-0554
- <option value="1F00E3CC-12EB-446D-99A4-DBA280AC4B39">
- Kraupner Pharmacy 457 Knickerbocker Ave,Brooklyn,NY,11237,718-821-1314,718-821-2665
- <option value="CEF2FC2B-F0B6-4B3C-A889-9CE13CFB95F4">
- Krutick Pharmacy 589 Crescent Street,Brooklyn,NY,11208,718-277-0573,718-277-0737
- <option value="CE62DDA8-D7D9-49B0-853A-11A701A6287E">
- L&S Pharmacy 424 Brighton Beach Avenue,Brooklyn,NY,11235,718-332-5881,718-891-7620
- <option value="FB4B3B95-FEE2-4A1C-A3C5-B12321C08F29">
- La Ruche Pharmacy, Inc 494 Rockaway Parkway,Brooklyn,NY,11212,718-485-6923,718-922-3287
- <option value="A648CA9D-63E1-4CAB-BF39-5888009BEAF9">
- Lane Drugs 4623 13th Ave,Brooklyn,NY,11219,718-439-1118,718-435-4908
- <option value="8F13E836-F1EF-407F-8225-83E92978A3A1">
- Lawrence Pharmacy 740 New Lots Ave,Brooklyn,NY,11207,718-649-0180,718-649-2720
- <option value="4F86A9D5-2296-4450-89A6-9D82EDD75D32">
- Leroy Specialty Pharmacy 2832 Linden Blvd.,Brooklyn,NY,11208,718-964-1130,718-964-1133
- <option value="2AFDACA1-6B2A-441F-8F97-AC2F80C219AF">
- Levys Pharmacy, Inc. 4021 13th Avenue,Brooklyn,NY,11218,718-633-4377,718-633-4378
- <option value="327D1E7D-EE2C-4B01-8C33-302815C405EA">
- Life Pharmacy 43-01 14th Ave,Brooklyn,NY,11219,718-438-1421,718-438-1483
- <option value="907571CE-FAC8-46AC-9C5A-47F4D278C903">
- Lincoln Neighborhood Pharmacy 730 Flatbush Ave,Brooklyn,NY,11226,718-284-0083,718-284-0551
- <option value="D0D6B72C-16AD-487F-B743-40DCAF56B8EC">
- Lincoln Place Pharmacy 1135 Eastern Pkway,Brooklyn,NY,11213,718-756-1717,718-604-1400
- <option value="3780AD28-498B-4A46-949F-7FEC40F27820">
- Linden Drugs 1368 Linden Blvd.,Brooklyn,NY,11212,718-342-3131,718-569-0073
- <option value="F6ACFB7A-2326-4CA5-A380-3BC974E81A17">
- LINDENWOOD RX CENTER 1380 LORING AVE,Brooklyn,NY,11208,718-277-0898,718-277-0895
- <option value="F0932494-3F83-4281-B77C-46F5474E916D">
- Linkus Pharmacy, Inc. 7213 18th Avenue,Brooklyn,NY,11204,718-837-8282,718-837-8082
- <option value="93BAB5DE-8010-4A73-BB94-8514B658DE81">
- Lins Pharmacy (Yi Rui Int.) 4311 8th Avenue,Brooklyn,NY,11232,347-221-0914,347-221-0915
- <option value="CFB55123-5C7D-4770-8AEF-10F68E87AF47">
- LMD Pharmacy 801 Avenue U,Brooklyn,NY,11223,718-627-1616,718-627-1618
- <option value="51186648-1251-47B0-A398-B54B43224826">
- Lobby Pharmacy 374 Stockholm St,Brooklyn,NY,112374006,718-963-7222,718-628-1568
- <option value="53629D98-52D8-419F-9F29-609581201075">
- Lorven Pharmacy LLC 1006 Manhattan Ave,Brooklyn,NY,11222,718-349-2255,718-349-2260
- <option value="CDD05110-8445-490F-9337-0CADA6FF4DEF">
- Loving Pharmacy, Inc 5711 6th Ave,Brooklyn,NY,11220,718-680-1982,718-680-1962
- <option value="CAF17D5C-B330-45B3-B4EF-2BB7E7EE8905">
- Luna Park Pharmacy 2875 West 8th Street,Brooklyn,NY,11224,718-946-5444,718-946-5355
- <option value="B8EAE826-E91B-4AA2-BBC2-FD80244035F7">
- M & M PHARMACY 1901 AVENUE M 19TH STREET,Brooklyn,NY,11230,718-377-7427,718-951-7520
- <option value="C439F814-45F1-429E-AE76-84A859100BA0">
- M I PHARMACY 85. E NEW YORK AVE,Brooklyn,NY,11203,718-493-8118,718-493-9187
- <option value="431A4C8F-0B71-4D87-A361-D3A2EDA241CC">
- Magnum Pharmacy, Inc. 1236 Fulton Street,Brooklyn,NY,11216,718-789-4645,718-789-4652
- <option value="A32FC292-F5D4-4FE6-9974-C34D44F06C43">
- Main Pharmacy 2361 86th Street,Brooklyn,NY,11214,718-372-2144,718-265-6614
- <option value="F6BB9277-A970-458A-903A-B776428252D7">
- MALLIK PHARMACY 2981 FULTON STREET,Brooklyn,NY,11208,718-827-8943,718-827-8195
- <option value="BF9D1C7F-A6A8-404E-BADC-4F5DF6CDD800">
- MANHATTAN BEACH PHARMACY, INC 87 WEST END AVE,Brooklyn,NY,11235,718-332-2210,718-332-5510
- <option value="4B5DE353-5F84-402A-A537-4730B5645B28">
- Manipal Drugs 280 Nostrand Avenue,Brooklyn,NY,11205,718-623-9533,718-399-6895
- <option value="1407E700-6EEF-4FA4-B372-5CA9BD52D77A">
- Mannings Pharmacy 64-02 8th Avenue,Brooklyn,NY,11220,718-238-3850,718-238-3856
- <option value="224B8176-3726-414C-8472-B4D2C14A7087">
- MARBEN PHARMACY 679 STANLEY AVE,Brooklyn,NY,11207,718-649-0200,718-305-1944
- <option value="4630F8AF-16EC-4005-BEAD-19D98394E105">
- MARBEN PHARMACY INC 679 STANLEY ST,Brooklyn,NY,11207,718-649-0200,718-305-1944
- <option value="717AFD87-B21A-4ABB-8DC0-94CD90C7C99E">
- Marcy Pharmacy 170 Throop Avenue,Brooklyn,NY,11206,718-384-5917,718-384-5917
- <option value="A83C5D3D-A18C-497C-AC53-03450AFF68D6">
- MARINO PHARMACY 167 WYCKOFF AVENUE,Brooklyn,NY,11237,718-497-3104,718-456-5141
- <option value="C3913E63-6DDF-4008-A885-C87A091C8E89">
- Marlboro Drug Co., Inc. 2313 Stillwell Avenue,Brooklyn,NY,11223,718-373-2600,718-266-5044
- <option value="8CCFCEDA-4AA1-402A-9BB8-E9A6FB0E1BCA">
- Maurice Pharmacy 802 Ave U,Brooklyn,NY,11223,347-462-2877,347-462-2875
- <option value="2FCCC7C7-63B8-4ACC-9007-3169D3BEFC41">
- Maxi Care Pharmacy 1645 Bedford Ave,Brooklyn,NY,11225,718-774-0600,718-774-8601
- <option value="4BC4EE85-6B7F-40DC-BFB9-D71D8D0C7172">
- MAYFLOWER PHARMACY 397 Kings Highway,Brooklyn,NY,11223,718-645-0999,718-645-0998
- <option value="AFB4BF44-F613-4A5E-BD5B-CE885EB215FA">
- Medical Arts Pharmacy 5504 13th Ave,Brooklyn,NY,11219,718-436-6088,718-436-3949
- <option value="169C73FB-1843-436F-9277-5FBB2FA795CD">
- MEDICINE DEPOT, INC 86 MANHATTAN AVENUE,Brooklyn,NY,11206,718-963-3923,718-963-3931
- <option value="2EB1F7D1-5A67-4074-8EDD-60A73E0DCB55">
- MEDICINE PLAZA PHARMACY 1312 KINGS HWY,Brooklyn,NY,11229,718-627-0800,718-627-5400
- <option value="82CD3A4D-3A7B-4EC4-8822-DE9E7AC6642E">
- MEDINA PHARMACY, INC. 5721 5TH AVE,Brooklyn,NY,11220,718-439-3500,718-439-5207
- <option value="903A5DE6-EA5E-4AD5-8209-55B6F66D5513">
- Mega Aid Pharmacy 3112 Mermaid Avenue,Brooklyn,NY,11224,718-333-9133,718-333-9133
- <option value="1C076C14-BF64-4C0A-8154-92F40EEB4B32">
- Mega Aid pharmacy Broadway 1013 BROADWAY,Brooklyn,NY,11221,347-533-4845,347-533-4844
- <option value="C3EA43CA-96A5-4C2E-BDC6-05A27CD748B4">
- Mellor Drug Store 3343 Fulton St,Brooklyn,NY,11208,718-277-5371,718-277-9836
- <option value="F4C1CE02-AE54-4F1B-AFDE-577D808D9A07">
- Memorial Pharmacy 699 92nd Street,Inside Victory memorial Hospital,Brooklyn,NY,11228,718-567-2661,718-567-2667
- <option value="86A7451D-32D4-41D3-A5D1-84A625CFA363">
- Metro Drugs 5027 New Ultrecht Ave,Brooklyn,NY,11219,718-431-8000,718-431-8943
- <option value="B0E8A6FE-876D-4558-93FE-D45761E0E89C">
- Metro Drugs, Inc. 4 Metro Tech Center,Brooklyn,NY,11245,718-522-5560,718-522-5627
- <option value="26E133D2-677D-4EC2-9FF8-4BFE90A7BFDB">
- Millenium Chemists 598 Clinton St,Brooklyn,NY,11231,718-923-1600,718-923-1600
- <option value="F594D51F-A94D-41F6-979F-B4208E4402AD">
- Millennium Pharmacy 3420 Fulton Street,Brooklyn,NY,11208,718-348-5000,718-348-5005
- <option value="B6C3903E-9641-4F3C-8339-53ECD3CA9C81">
- Mishkin Pharmacy 1153 Broadway,Brooklyn,NY,11221,718-452-3261,718-455-5345
- <option value="342D8B64-E1A9-49A8-9EF6-7E23E60DB5C2">
- Mittmans Pharmacy 167 Have Mayer Street,Brooklyn,NY,11211,718-384-2387,718-384-8178
- <option value="9880BAC3-727C-493D-AF58-6265F4C3D6BF">
- Mittmans Pharmacy 167 Have Mayer Street,Brooklyn,NY,11211,718-384-8178,718-384-2387
- <option value="63F8368F-09EB-475F-84AE-8A0A540FA5CF">
- MMC HOLDING OF BROOKLYN 948 48TH STREET,Brooklyn,NY,11219,718-438-1114,718-283-8220
- <option value="52637146-B249-47BB-AE2E-98B2C50249EB">
- moms pharmacy inc 821 franklin ave,Brooklyn,NY,11225,718-467-5898,718-467-3873
- <option value="18D970C2-2285-40C0-B6B1-690C9CDC0BBC">
- Murawski Pharmacy 94-98 Nassau Avenue,Brooklyn,NY,11222,718-389-7600,718-349-2517
- <option value="1EDA3CF7-2136-4FE0-9C6E-447A740BDE34">
- Myrtle Pharmacy Inc 446-A Myrtle Ave,Brooklyn,NY,11205,718-237-4444,718-237-1414
- <option value="D950EC0F-C502-4189-B7E4-547F51ACFCE7">
- Napolitano Pharmacy 335 Graham Ave,Brooklyn,NY,11211,718-387-0124,718-387-0946
- <option value="858A7E09-4F90-48B9-A0EA-23F501942E26">
- Nates Pharmacy 7124 Bay Parkway,Brooklyn,NY,11204,718-236-3274,718-236-6630
- <option value="A822FB58-A712-4D66-B664-7F04415F8FE3">
- Nates Pharmacy 376 Van Brunt Street,Brooklyn,NY,11231,718-797-0200,718-797-5090
- <option value="C5AC31C7-92E3-4259-916A-CA1EDAD2C72F">
- Nates Pharmacy 329 A Myrtle Ave,Brooklyn,NY,11205,718-596-0202,718-596-6759
- <option value="AFEF1F64-B6F7-4710-8146-54F92FD3BA6D">
- NATURES EMPORIUM 1601 KINGS HWY,Brooklyn,NY,11229,718-375-7877,718-382-5445
- <option value="3FE56218-F808-4081-ADA7-51F99D0BD4F2">
- Neergard Pharmacy 120 7th ave,Brooklyn,NY,11215,718-857-1600,718-398-6559
- <option value="B125A78F-73D3-4320-9C9A-07BB9BA1C382">
- Neergard1 Pharmacy 454 5th Ave,Brooklyn,NY,11215,718-768-0600,718-832-2912
- <option value="AE7841FE-5BEA-424F-BE31-062C489ED005">
- Neighbor Care 2315 65th Street,Brooklyn,NY,11204,718-336-4772,718-336-9069
- <option value="2099E5C9-8CDE-4FF5-89CF-31215AE83E1A">
- Neighbor Friendly Pharmacy 712 Myrtle Ave,Brooklyn,NY,11205,718-855-8066,718-855-8818
- <option value="2234E22F-F214-46FE-B199-93A1D06AEA35">
- NEIGHBORHOOD DRUGSTORE 8410 5TH AVENUE,Brooklyn,NY,11209,718-759-9500,718-759-1411
- <option value="F05B0365-9A28-4A61-AD22-5E6FC0B7F830">
- Neptune Pharmacy, Inc. 3080 Coney Island Avenue,Brooklyn,NY,11235,718-332-5263,718-368-2710
- <option value="F6BCA715-6FA0-4E3D-89CA-204AB3CAAEBD">
- NEUGARD PHARMACY 7323 3RD AVE,Brooklyn,NY,11209,718-748-9300,718-748-6904
- <option value="F8F77229-69EF-4579-ABE5-C3797EE58DBE">
- Nevins Pharmacy 326 Livingston St,Brooklyn,NY,11217,718-422-0100,718-422-0118
- <option value="E4641216-ACBA-424B-8782-BF31E6601798">
- New Age Pharmacy 2918 ave J,Brooklyn,NY,11210,718-253-1700,718-253-8777
- <option value="D969E0AA-653B-4691-9C25-D47977D79B7E">
- New Express Pharmacy 99 church Avenue,Brooklyn,NY,11218,718-438-4300,718-438-4300
- <option value="26D0AEEF-1E67-48A3-BEE8-89D8A68999A9">
- New Lots Care Pharmacy, Inc. 404 New Lots Avenue,Brooklyn,NY,11207,718-484-0700,718-484-0701
- <option value="8B044A7D-ABFA-4121-8C87-26D7EB3C9997">
- New Lots Pharmacy 739 New Lots Ave,Brooklyn,NY,11207,718-649-9535,718-649-3456
- <option value="C3DB31C8-BB2E-44F5-B670-BE9358465A6B">
- New Lots Pharmacy 475 New Lots Avenue,Brooklyn,NY,11027,718-272-4566,718-554-3980
- <option value="78360F8F-EB6A-41B9-8D7C-2BDF640CFAC9">
- New Ronson Drugs 237 Utica Ave,Brooklyn,NY,11213,718-756-7401,718-735-2966
- <option value="27F3E40C-2CAE-4477-869E-DC5B3039F37D">
- New Trend Pharmacy 3401 AVenue H,Brooklyn,NY,11210,718-859-3000,718-421-6185
- <option value="00CAB6D3-EDF4-4789-85FA-D3CF7D8B1EF0">
- NEW UTRECHT PHARMACY 4624 NEW UTRECHT AVENUE,Brooklyn,NY,11219,718-436-9300,718-854-6116
- <option value="5EAFB424-7D33-4451-80F3-A96ABE6FCE14">
- New Victory Pharmacy 9202 4th Avenue,Brooklyn,NY,11209,718-745-5100,718-238-4615
- <option value="032F8B8F-7026-4062-8B9E-5960DBD41AF7">
- NEW YORK AVENUE PHARMACY 3223 CHURCH AVE,Brooklyn,NY,11226,718-856-8048,718-469-0424
- <option value="490DDCC0-1ED1-4DC8-A110-EA1B863CC991">
- New York Drugs & Surgicals, 6112 Fifth Avenue,Brooklyn,NY,11220,718-439-4966,718-439-4972
- <option value="2A485917-F669-4986-9751-EBF63B6EF65E">
- Nextgen Pharmacy, Corp. 2483 86th Street,Brooklyn,NY,11214,718-767-9191,718-767-9193
- <option value="0FB2236B-FDF6-40E6-832A-E6B7AA5D3110">
- Noha Pharmacy, Inc. 291 Knickerbocker Avenue,Brooklyn,NY,11237,718-456-5475,718-501-1003
- <option value="6FC31F86-9585-4E68-8501-D0C7B6299D31">
- Noor Pharmacy, Inc. 2036 Bedford Avenue,Brooklyn,NY,11226,718-503-4790,718-986-1566
- <option value="6FD4E710-6A33-4130-83A6-74E3B0961B95">
- Northside Pharmacy 182 Bedford,Brooklyn,NY,11211,718-387-6566,718-782-7101
- <option value="9FF23CB7-45EC-4480-AE4B-AB38CEDF24A3">
- Nostran House Pharmacy 3031 Ave V,Brooklyn,NY,11229,718-332-0040,718-332-1171
- <option value="2B04B52A-246E-4D81-A097-24B1E4C2A1C2">
- NOTTINGHAM PHARMACY 1930 AVENUE M,Brooklyn,NY,11230,718-375-2400,718-375-3805
- <option value="58326BEA-D559-4F05-AE7D-EEF0AF24A44F">
- Nu Edge Pharmacy 7707 Fifth Ave,Brooklyn,NY,11209,718-748-4082,718-748-4156
- <option value="587037B5-85DA-4B3E-88D2-6B02A1EBF647">
- NY Central Pharmacy 252 Brighton Beach Ave.,Brooklyn,NY,11235,718-646-2222,718-646-2225
- <option value="B86F17DF-6F46-4AE1-B2CF-9417FFF982E9">
- Oak Park Pharmacy 205 Prospect Park West,Brooklyn,NY,11215,718-768-6300,718-768-6487
- <option value="B988726E-FFE5-4B83-9C51-C834DE006A72">
- Ocean Pharmacy 1929 Kings Highway,Brooklyn,NY,11229,718-998-9595,718-998-0566
- <option value="1F1A64C9-56E6-456A-A389-343F83CD383E">
- Ocean Pharmacy #2 915 107th Street,Brooklyn,NY,11229,718-272-2282,718-272-2676
- <option value="882074EC-21AD-4741-BF79-E205ED970F0F">
- OCEAN PHARMACY SERVICES,INC. 436 AVE P,Brooklyn,NY,11223,718-339-8118,718-339-6385
- <option value="E8330768-F86A-4781-A5CA-B25DA989C32B">
- Ocean U Pharmacy 2001 Avenue U,Brooklyn,NY,11229,718-332-3380,718-332-2638
- <option value="CA45391D-31A2-41EA-AAC9-CBD47886455A">
- Oceania Pharmacy 415 Brighton Beach Ave.,Brooklyn,NY,11235,718-769-5777,718-769-8080
- <option value="B17ECBD6-A8CF-4B9E-9529-80BB4ECD9A41">
- Oceanside Pharmacy 3206 Mermaid Ave,Brooklyn,NY,11224,718-996-9563,718-996-5392
- <option value="2EF7D448-B766-4446-A70A-75E8CDA8E4CD">
- PAKAM PHARMACY INC. 597 MARCY AVE,Brooklyn,NY,11206,718-486-5255,718-486-7210
- <option value="AD7C564F-A62C-4D68-A9A3-5438879B1F8F">
- Palm Gate Pharmacy 583 Knickerbocker Ave,Brooklyn,NY,11221,718-381-1508,718-428-2263
- <option value="8F88E355-772C-453E-BC5B-47A4199CD26A">
- PALMA CHEMISTS 159 7TH AVE,Brooklyn,NY,11215,718-638-9617,718-398-6631
- <option value="1F0041F3-3D77-46EA-BE1F-17BD38B94484">
- Paras Pharmacy 2070 Bath Ave,Brooklyn,NY,11214,718-372-8795,718-372-9419
- <option value="B29A0E0C-9854-4D63-8C41-485003A2B945">
- Park Drugs (SanRx, Inc.) 540 Eastern Parkway,Brooklyn,NY,11225,718-953-4548,718-953-4601
- <option value="085C82F5-1937-4683-AE84-8B5CE9F43A12">
- Park Pharmacy 3205 Quenton Rd,Brooklyn,NY,11234,718-645-3200,718-645-3205
- <option value="32986DA0-C01D-4ACC-827B-BC6544CCA3F1">
- Parkway Pharmacy 531 Church Ave.,Brooklyn,NY,11218,718-436-5501,718-437-9490
- <option value="0FFD8493-1C43-4E48-BCF7-82AA9B5A16DE">
- PARMRX EXPRESS PHARMACY 1311 GRAVESEND NECK RD,Brooklyn,NY,11229,718-627-7070,718-627-7374
- <option value="494F0698-3E66-4078-A0AF-8CBA756DCE47">
- PATHMARK #72-619 625 ATLANTIC AVE,Brooklyn,NY,11217,718-399-6239,718-399-6392
- <option value="BCF48AFC-B17A-49C1-A0AF-934C2C2041E2">
- PATHMARK #72-624 1260 60TH STREET,Brooklyn,NY,11219,718-853-8645,718-853-6469
- <option value="7BB3172E-8AB1-4F5F-B0DE-BC34E8F8AD4A">
- PATHMARK #72-634 11110 FLATLANDS AVE,Brooklyn,NY,11207,718-649-2522,718-272-5254
- <option value="774B3F29-6343-43A9-A703-F03E6294F6F2">
- PATHMARK #72-637 1525 ALBANY AVE,Brooklyn,NY,11210,718-859-2500,718-859-0598
- <option value="9BDC447C-0B5F-42B7-B3DE-40CC54606AF4">
- PATHMARK #72-638 2965 CROPSEY AVE,Brooklyn,NY,11214,718-266-2845,877-562-0841
- <option value="2047118F-DB2C-41BF-B3FE-581A617AF164">
- Penn-Sutter Pharmacy 642 Sutter Avenue,Brooklyn,NY,11207,718-346-9512,718-346-7059
- <option value="6F0341DC-84B6-4A75-A1A5-D6C8F368A959">
- Personal Care Pharmacy 836 Coney Island Avenue,Brooklyn,NY,11218,718-282-7375,718-282-2731
- <option value="981C8B48-315A-4BA0-8DBE-989B705F086C">
- PHARMACIA POPULAR 17 MARCUS GARVEY BLVD,Brooklyn,NY,11206,718-218-9346,718-218-9435
- <option value="CD524D53-623D-4FF8-BA40-078E32D0D017">
- Pharmacy Express 1081 Rutland Road,Brooklyn,NY,11212,718-493-4199,718-771-8555
- <option value="63834A31-0C3F-4B6B-A9E8-32623B123837">
- Pharmacy Express LLC 701 Flatbush Ave,Brooklyn,NY,11225,718-282-5800,718-282-5800
- <option value="582C7ED3-1AB9-4F06-A8DB-E2686C009CD8">
- Pharmacy On Fifth Inc 6914 5th Ave,Brooklyn,NY,11209,718-238-9600,718-238-9719
- <option value="F64692AB-A0E1-4344-8D43-F65837226AA4">
- Pharmore Drugs 510 Ocean Ave,Brooklyn,NY,11226,718-282-3600,718-282-7066
- <option value="A4BC6CAE-DDF9-478A-8860-945F0E14417A">
- Pitkin Care Pharmacy 1621 Pitkin Ave,Brooklyn,NY,11212,718-498-1142,718-498-1150
- <option value="0A916F66-F5A7-4224-A3B1-F95BD03DC88D">
- Pitkin Pharmacy 2232 Pitkin Avenue,Brooklyn,NY,11207,718-485-3724,718-495-3290
- <option value="1AB83B3B-50BD-4EC5-88EF-D8C389DB0477">
- PL Pharmacy dba Lowens Pharm 6902 3rd ave,Brooklyn,NY,11209,718-238-2444,718-921-6104
- <option value="1B59EF94-EEAB-419C-9E04-D0FBA73404C5">
- Powells Pharmacy 7517 3rd ave,Brooklyn,NY,11209,718-745-2660,718-680-7431
- <option value="375A792F-7704-4FFD-8899-04AD5246E4D9">
- Premium Pharmacy 829 57th Street Unit 1,Brooklyn,NY,11220,718-484-4628,718-484-4630
- <option value="FFF3BB2F-2F10-447B-80D6-1F555F7AE44C">
- Prime Care Pharmacy, Inc. 1126 Nostrand Avenue,Brooklyn,NY,11225,718-953-7300,718-953-4418
- <option value="76F69B15-5B42-44CD-BC6A-50F57B7E0A47">
- Princess Rx d/b/a Hastings P 2061 Atlantic Avenue,Brooklyn,NY,11233,718-485-5095,718-485-5097
- <option value="ECBCB933-1579-4DC9-AF96-4958BBB314F6">
- Prospect Drugs 94 Greene Ave,Brooklyn,NY,11238,718-783-0890,718-783-0893
- <option value="2016B8A9-9DE5-467D-8563-4EA9E0C46E21">
- PUNJAB PHARMACY 1018 CONEY ISLAND AVE,Brooklyn,NY,11230,718-434-4000,718-421-1697
- <option value="F61B68BB-BBAF-4852-AF33-A0B3DD3139CA">
- QUALICARE PHARMACY 8312 3RD AVE,Brooklyn,NY,11209,718-748-3001,718-748-3006
- <option value="C54BA49D-DE99-4B9D-801B-52080AD700FD">
- Qualimeds Pharmacy 2272 86 Street,Brooklyn,NY,11214,718-872-5737,718-872-5723
- <option value="C43F5F1A-3728-4136-8B09-67045EEA9295">
- QUICK AID PHARMACY 38 14 13TH AVE,Brooklyn,NY,11218,718-854-7722,718-871-0093
- <option value="BAD4F32D-751B-4FF7-A68C-64B86192EC04">
- Quick Stop Pharmacy 7210 20th Ave,Brooklyn,NY,11204,718-256-3400,718-256-3456
- <option value="AA98F7DD-6840-4638-85A1-F02FDF0A7A05">
- QUICKRX PHARMACY 360 KNICKERBOCKER AVENUE,Brooklyn,NY,11237,718-455-1301,718-360-1832
- <option value="1F5D0EC9-2A28-46FA-B276-A1CFD04ADF39">
- Radin Pharmacy 1077 Brighton Beach Avenue,Brooklyn,NY,11235,718-769-2043,718-743-4645
- <option value="FF662140-0796-43FA-A9CB-D9E54AF204D7">
- Rafieh Phcy 70 LEE AVENUE,Brooklyn,NY,11211,718-387-0021,718-782-0383
- <option value="14393CDA-189B-4DAF-934B-1582A02C2915">
- RALPH PRESCRIPTIONS INC 300 WYCKOFF AVE,Brooklyn,NY,11237,718-456-3156,718-417-7159
- <option value="4FA8850B-81E6-4DB5-8293-58721AE95E63">
- Regency Drugs 7115 3rd Ave,Brooklyn,NY,11209,718-238-7488,718-238-7486
- <option value="16B9E64E-D730-487B-9BA0-F7D87D995EDA">
- Remedies Pharmacy 711 Bedford Ave,Brooklyn,NY,11206,718-855-0214,718-855-0214
- <option value="B67020F9-D9E2-44F8-9339-599323D2694E">
- Ridgewood City Pharmacy 775 Seneca Avenue,Brooklyn,NY,11385,718-366-7766,718-366-7755
- <option value="0E0B16A6-B697-4891-A3C7-40245E9E9A1D">
- Rimco Pharmacy 623 Wilson Ave,Brooklyn,NY,11207,718-919-9131,718-919-5060
- <option value="93316C10-0039-4998-A4FC-6D70F4ACFEE2">
- Rio Drugs 701 Broadway,Brooklyn,NY,11206,718-599-1172,718-599-3073
- <option value="BDCB96FF-3BC7-420C-99B5-2CC08C7B3146">
- RITE AID- 1631-43 PITKIN AVE 1631-43 PITKIN AVENUE,Brooklyn,NY,112125050,718-498-9530,718-922-9871
- <option value="3EBF40B8-F4D7-4D66-A262-0604796CF568">
- RITE AID- 506-528 UTICA AVE 506-528 UTICA AVENUE,Brooklyn,NY,112031321,718-604-1323,718-604-9354
- <option value="BCBD9A41-85E5-448C-B570-32FB314F064C">
- RITE AID- 559-563 FULTON ST 559-563 FULTON STREET,Brooklyn,NY,112015309,718-643-3570,718-643-9168
- <option value="B2EC52C6-D9AA-4E83-8DCC-70BB3700A1A5">
- RITE AID- 6201-23 4TH AVE 6201-23 FOURTH AVENUE,Brooklyn,NY,112204615,718-567-9476,718-567-0340
- <option value="EDC6DEF4-B6B5-4584-989B-F131A0A7BFF3">
- RITE AID- 892-908 FLATBUSH 892-908 FLATBUSH AVENUE,Brooklyn,NY,112264018,718-856-8841,718-462-8848
- <option value="14E65BFD-EA13-40C3-8EE4-2C109CCA9D67">
- RITE AID-1040 ST JOHNS PLACE 1040 SAINT JOHNS PLACE,Brooklyn,NY,112132533,718-953-7150,718-778-8467
- <option value="EF2BE4E9-D283-41E7-8FF0-F7638074FF2D">
- RITE AID-1111 PENNSYLVANIA 1111 PENNSYLVANIA AVENUE,Brooklyn,NY,112079064,718-272-0346,718-257-5746
- <option value="9431CB5D-6F73-426D-A20A-EF31FD5324AE">
- RITE AID-1154 CLARKSON AVE 1154 CLARKSON AVENUE,Brooklyn,NY,112122706,718-345-6355,718-385-9775
- <option value="55C177D9-A3E9-475B-975A-0FCC27DF6537">
- RITE AID-120 COURT ST. 120 COURT STREET,Brooklyn,NY,112015607,718-643-2146,718-643-4520
- <option value="D1E9CC29-6249-4C59-9C0E-776BBF7B6E4B">
- RITE AID-1380 ROCKAWAY PKWY 1380 ROCKAWAY PARKWAY,Brooklyn,NY,112362322,718-272-1107,718-566-7562
- <option value="FE1C1EE1-BBE9-4A80-A89E-5B1B10EF7D48">
- RITE AID-1419 NEWKIRK AVE 1419 NEWKIRK AVENUE,Brooklyn,NY,112266521,718-940-1794,718-469-6687
- <option value="B9F3AACC-B2D5-4B84-A31B-218DE5C01391">
- RITE AID-1532-34 86TH ST 1532-34 86TH STREET,Brooklyn,NY,112283431,718-234-8444,718-234-9455
- <option value="7C32EE23-7071-43FF-8F98-78E198E5AD69">
- RITE AID-1559 FLATBUSH AVE 1559 FLATBUSH AVENUE,Brooklyn,NY,112103041,718-434-5755,718-434-2742
- <option value="9E1E60FA-9558-49C7-9A1D-86DA62783E72">
- RITE AID-1679 BEDFORD AVE 1679 BEDFORD AVENUE,Brooklyn,NY,112252601,718-282-7476,718-282-0738
- <option value="5EF48524-03C3-428E-A2D2-53EECEDD3D99">
- RITE AID-168 MONTAGUE ST 168 MONTAGUE STREET,Brooklyn,NY,112013615,718-522-2991,718-625-9259
- <option value="E329962D-B08A-4145-8759-A7A89B1982D2">
- RITE AID-1720 KINGS HWY 1720 KINGS HIGHWAY,Brooklyn,NY,112291208,718-998-3377,718-376-5686
- <option value="C89C4AE7-B4AB-46D1-8343-8D20D681A876">
- RITE AID-1791 UTICA AVE 1791 UTICA AVENUE,Brooklyn,NY,112342120,718-241-3559,718-451-3537
- <option value="54D2C23A-5D51-469A-AF8B-74DED09E0049">
- RITE AID-182 SMITH ST 182 SMITH STREET,Brooklyn,NY,112016409,718-246-4226,718-246-4274
- <option value="A9C41D44-05FF-4ADC-960F-825AFF41FD33">
- RITE AID-185 KINGS HWY 185 KINGS HIGHWAY,Brooklyn,NY,112231105,718-331-2019,718-331-5384
- <option value="F69E6E4B-7B46-4470-8B72-90F2C2A9C435">
- RITE AID-1950 FULTON ST 1950 FULTON STREET,Brooklyn,NY,112333104,718-493-0854,718-493-6512
- <option value="F9990E83-DEA5-4066-A228-2FF45B5E82B1">
- RITE AID-2002 AVENUE U 2002 AVENUE U,Brooklyn,NY,112293908,718-769-2058,718-332-2127
- <option value="160BB432-CF3F-45DD-8857-D8D27AE5B1B3">
- RITE AID-2007 86TH AVE 2007 86TH STREET,Brooklyn,NY,112143203,718-373-8185,718-449-6850
- <option value="B41DA969-361B-4C1C-8554-659198442704">
- RITE AID-2064 MILL AVENUE 2064 MILL AVENUE,Brooklyn,NY,112345922,718-531-0408,718-531-2986
- <option value="DF511F84-24E0-4213-9131-04DA9EBF1EE7">
- RITE AID-2221 65TH STREET 2221 65TH STREET,Brooklyn,NY,112044001,718-259-9378,718-234-6748
- <option value="0C67E3CD-F28C-4922-8F32-CA29495A11C7">
- RITE AID-2324 FLATBUSH AVE 2324 FLATBUSH AVENUE,Brooklyn,NY,112344518,718-951-6869,718-951-9105
- <option value="8206D8A0-E71D-4636-979D-ED428927195B">
- RITE AID-237-241 AVENUE U 237-241 AVENUE U,Brooklyn,NY,112233817,718-946-4370,718-373-9149
- <option value="29BFFC43-E060-45C3-9970-BBDF83FAB81E">
- RITE AID-249 7TH AVE 249 7TH AVENUE,Brooklyn,NY,112153610,718-768-9567,718-369-8861
- <option value="F264BDC7-35EF-4FE9-9544-64A570FAD42E">
- RITE AID-2532-54 86TH ST 2532-54 86TH STREET,Brooklyn,NY,112144439,718-946-6490,718-266-2074
- <option value="0CBEC300-751E-493E-9A53-AB3DB8E227BE">
- RITE AID-2577 NOSTRAND AVENUE 2577 NOSTRAND AVENUE,Brooklyn,NY,112104640,718-258-1812,718-951-2348
- <option value="61EF74F4-FC80-43F8-97E9-113AD91ABA9E">
- RITE AID-2819 CHURCH AVE 2819 CHURCH AVENUE,Brooklyn,NY,112264168,718-940-3461,718-462-6057
- <option value="A41CD76C-1ACE-4019-B903-547A5B3F3FAD">
- RITE AID-2981 OCEAN AVENUE 2981 OCEAN AVENUE,Brooklyn,NY,112353432,718-332-1001,718-891-0814
- <option value="9F7C656E-6582-4897-936D-E0CC254D8AEA">
- RITE AID-3001-27 MERMAID AVE 3001-27 MERMAID AVENUE,Brooklyn,NY,112241805,718-373-2818,718-265-3789
- <option value="B0DCD696-89D1-4537-A47B-66A2F221D16F">
- RITE AID-302 CHURCH AVE 302 CHURCH AVENUE,Brooklyn,NY,112183106,718-437-7765,718-686-0458
- <option value="EBF36501-DC7C-4665-A43C-72DDF809B085">
- RITE AID-320 SMITH STREET 320 SMITH STREET,Brooklyn,NY,112314608,718-403-9371,718-403-9376
- <option value="A046F517-8D3B-473E-A73C-1B2695FE2440">
- RITE AID-344 AVENUE X 344 AVENUE X,Brooklyn,NY,112235914,718-375-8257,718-375-9206
- <option value="76725D80-09AC-4131-86D0-14AF6B6ADAC2">
- RITE AID-355 KNICKERBOCKER 355 KNICKERBOCKER AVENUE,Brooklyn,NY,112373740,718-821-2678,718-821-1336
- <option value="59129301-3CD4-4CB6-8181-EF92CA7E8D9B">
- RITE AID-3823 NOSTRAND AVE 3823 NOSTRAND AVENUE,Brooklyn,NY,112352012,718-743-8933,718-332-2381
- <option value="9F261FC5-DCDC-4080-B57B-22CEEE128262">
- RITE AID-4102 CHURCH AVE. 4102 CHURCH AVENUE,Brooklyn,NY,112033006,718-940-1579,718-469-7283
- <option value="F8D2AD33-A91F-4DA5-90E0-9117889128C8">
- RITE AID-4123 AVENUE D 4123 AVENUE D,Brooklyn,NY,112035705,718-629-2275,718-451-3748
- <option value="A3D6774C-2214-497F-B592-75187DBA2277">
- RITE AID-462 FIFTH AVE 462 FIFTH AVENUE,Brooklyn,NY,112154004,718-499-7500,718-499-3547
- <option value="1679EB2D-151C-4E41-9EBA-BFE8AECCC6D4">
- RITE AID-5102 13TH AVE 5102 13TH AVENUE,Brooklyn,NY,112193520,718-435-5684,718-435-9490
- <option value="CB7FAF1F-4C54-46D1-995D-0F69098D78E0">
- RITE AID-5224 FIFTH AVE 5224 FIFTH AVENUE,Brooklyn,NY,112202709,718-765-1833,718-765-0267
- <option value="DC53884F-336C-47FA-AA43-D4174377DED2">
- RITE AID-5901 BAY PKWY 5901 BAY PARKWAY,Brooklyn,NY,112042566,718-236-6366,718-331-2094
- <option value="BCD64C24-35BC-4FAB-B478-8449362965E6">
- RITE AID-6101 18TH AVE 6101 18TH AVENUE,Brooklyn,NY,112042302,718-236-0146,718-259-4421
- <option value="F31E0B6F-4BBA-4BAF-A034-040B88385957">
- RITE AID-6423 FORT HAMILTON P 6423 FORT HAMILTON PKWY.,Brooklyn,NY,112195520,718-567-0890,718-567-0968
- <option value="8923A749-A1C7-4D75-8790-F60A8DB2F94D">
- RITE AID-6900 4TH AVE 6900 4TH AVENUE,Brooklyn,NY,112091502,718-748-8184,718-765-0397
- <option value="731612B0-C896-471B-971C-A8D933A06AE4">
- RITE AID-7009 13TH AVENUE 7009 13TH AVENUE,Brooklyn,NY,112281603,718-256-1761,718-256-6851
- <option value="90F36C98-16F0-41F2-AC4C-42AC0A228BD1">
- RITE AID-7118 3RD AVENUE 7118 3RD AVENUE,Brooklyn,NY,112091309,718-745-2830,718-836-4644
- <option value="EB81513F-3B15-4E3D-85BD-4389536672D8">
- RITE AID-723-725 MANHATTAN AV 723-725 MANHATTAN AVENUE,Brooklyn,NY,112222909,718-383-7967,718-389-2569
- <option value="AD5439E6-1A2A-4229-B293-9A1DECDF6599">
- RITE AID-7501 5TH AVENUE 7501 5TH AVENUE,Brooklyn,NY,112093301,718-492-4495,718-492-8669
- <option value="A3685AD7-3105-4D74-ACD5-D91BA5F600C2">
- RITE AID-7812 FLATLANDS AVE 7812 FLATLANDS AVENUE,Brooklyn,NY,112363530,718-531-5023,718-968-9690
- <option value="C89A7C21-304C-4A72-98AC-A54927447863">
- RITE AID-7821 3RD AVE 7821 3RD AVENUE,Brooklyn,NY,112093605,718-630-5482,718-765-1207
- <option value="DE3B91F9-DF9C-43A5-8F1E-C3D20851CE79">
- RITE AID-783 MANHATTAN AVE 783 MANHATTAN AVENUE,Brooklyn,NY,112222710,718-383-6150,718-389-2269
- <option value="83C98149-3FBE-4D1F-B7E2-356294E7E219">
- RITE AID-8222 18TH AVENUE 8222 18TH AVENUE,Brooklyn,NY,112142901,718-256-6635,718-236-5870
- <option value="C8089740-7F6A-4252-AAB3-A633EE453C17">
- RITE AID-9302 3RD AVE 9302 3RD AVENUE,Brooklyn,NY,112096802,718-491-0442,718-491-6155
- <option value="1517CE53-CCF1-4BEF-9FEA-05725630A837">
- RITE AID-960 HALSEY ST 960 HALSEY STREET,Brooklyn,NY,112331403,718-602-1607,718-602-2714
- <option value="58973D10-2C7B-44CE-B382-96111E6AAB8D">
- RITE AID-9738 SEA VIEW AVE 9738 SEA VIEW AVENUE,Brooklyn,NY,112365516,718-968-1584,718-451-4718
- <option value="833FB51E-432B-4F3E-8B1E-DB33CE193440">
- Rite Choice Pharmacy 1484 Fulton St.,Brooklyn,NY,11216,718-773-3700,718-773-4425
- <option value="1118516E-62B1-40C9-A589-532DABFDE840">
- Rite-Care Pharmacy 677 4th Ave,Brooklyn,NY,11232,718-499-7410,718-499-7423
- <option value="87D032F1-E269-4BB8-8FF3-396DBB76B9B9">
- Rockaway Pharmacy 1214 Flatbush Avenue,Brooklyn,NY,11226,718-462-6527,718-462-6479
- <option value="CAFD768F-A07E-48D8-AAED-5C5B3DC4BF51">
- ROCKAWAY RX 710 ROCKAWAY AVE,Brooklyn,NY,11212,718-498-2277,718-922-5642
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- Rose Pharmacy 1074-A Liberty Ave,Brooklyn,NY,11208,718-235-3383,718-235-3381
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- Rosenblum/Santa Maria Pharma 255 S. 2nd Steet,Brooklyn,NY,11211,718-388-0745,718-486-8488
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- Ross Pharmacy, Inc. 4908 Church Avenue,Brooklyn,NY,11203,718-693-4138,718-640-1691
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- Rossi Pharmacy 1891 Eastern Pkway,Brooklyn,NY,11233,718-346-2506,718-346-2534
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- Royal Pharmacy-Brooklyn 2239 Church Ave.,Brooklyn,NY,11226,718-941-7722,718-941-0023
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- RSP Pharmacy 410 Tompkins Ave,Brooklyn,NY,11216,718-789-3220,718-789-8581
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- RUBIN CHEMIST 828 NOSTRAND AVE,Brooklyn,NY,11218,718-493-8833,718-604-1392
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- Rutland Pharmacy 964 Rutland Road,Brooklyn,NY,11212,718-774-9613,718-774-9613
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- RX CHOICE PHARMACY 1908 AVE U,Brooklyn,NY,11229,718-368-1190,718-368-0665
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- Rx Circle Pharmacy Corp 5001 7th avenue,Brooklyn,NY,11220,718-686-8280,718-686-8281
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- Rx Express Pharmacy 6716 18th Avenue,Brooklyn,NY,11204,718-232-2288,718-232-0034
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- Rx stop pharmacy 8610 BAY PARKWAY,Brooklyn,NY,11214,718-449-6092,718-372-5637
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- Rx Warehouse Pharmacy 7724 New Utrecht Avenue,Brooklyn,NY,11214,718-236-1212,718-236-1211
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- Rx Warehouse Pharmacy, Inc. 7724 New Utrecht Avenue,Brooklyn,NY,11214,718-236-1212,718-236-1211
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- S & E DRUGS INC 1200 FULTON ST,Brooklyn,NY,11216,718-398-9000,718-398-0122
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- S & N Rx (Michaels Ph.) 163 Linden Blvd.,Brooklyn,NY,11226,718-284-2199,718-284-1182
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- S & T PHARMACY 391 EASTERN PARKWAY,Brooklyn,NY,11216,718-756-6026,718-953-3720
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- S. Bros. Pharmacy 176 Lee Ave,Brooklyn,NY,11211,718-855-3070,718-596-4657
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- Saiven Pharmacy 881 Manhattan Ave,Brooklyn,NY,11222,718-389-0900,718-389-2299
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- SALDO DRUGS 384 GRAHAM AVE,Brooklyn,NY,11211,718-389-8015,718-389-8136
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- Saltzman Pharmacy 96 Third Avenue,Brooklyn,NY,11217,718-625-0141,718-222-0141
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- SAM DRUGS 1367 BROADWAY,Brooklyn,NY,11221,718-453-6866,718-452-2686
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- SAMICA PHARMACY INC 6407 BAY PARKWAY,Brooklyn,NY,11204,718-234-4211,718-676-7120
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- Santa Maria / Rosenblum Phar 255 So. Second Street,Brooklyn,NY,11211,718-388-0745,718-388-0745
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- SAULS PHARMACY 3514 MERMAID AVE,Brooklyn,NY,11224,718-265-9108,718-265-5327
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- SBC RX 120 Richards Street,Brooklyn,NY,11231,718-852-0269,718-852-6429
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- Scarpa Pharmacy 6216 11th ave,Brooklyn,NY,11219,718-745-5499,718-921-4661
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- SDF Pharmacy 302 BROADWAY,Brooklyn,NY,11211,718-384-1544,718-599-4632
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- Sea Breeze Pharmacy & Med. S 1129 Brighton Beach,Brooklyn,NY,11235,718-646-0660,347-587-6214
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- Shifa Pharmacy 2001 Bath Ave,Brooklyn,NY,11214,718-266-2266,718-266-2289
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- SHOPRITE PHARMACY #218 1080 MCDONALD AVE,Brooklyn,NY,11230,718-252-8510,718-252-5650
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- SILVER OAK PHARMACY,INC. 5105 Church Ave,Brooklyn,NY,11203,718-240-9924,718-240-9211
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- Silver Rod Pharmacy 64-04 18th Ave,Brooklyn,NY,11204,718-236-5705,718-234-0961
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- Silver Rod Pharmacy 5001 Church Avenue,Brooklyn,NY,11203,718-922-3400,718-922-0348
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- SIMS PHARMACY INC. 1711 PITKIN AVENUE,Brooklyn,NY,11212,718-346-7200,718-495-1321
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- Sisto Pharmacy 675 Grand Street,Brooklyn,NY,11211,718-387-2665,718-486-8314
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- Slope Drugs and Surgical Sup 406 Fifth Ave,Brooklyn,NY,11215,718-788-8899,718-768-4688
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- SMART CHOICE PHARMACY 259 AVE X,Brooklyn,NY,11223,718-339-3400,718-339-5239
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- Smart Health Pharmacy, Inc. 547 86 Street,Brooklyn,NY,11209,718-238-2725,718-238-2095
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- Southside Drugs, Inc. 432 Bedford Avenue,Brooklyn,NY,11211,718-782-7200,718-782-7211
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- Spectrum Pharmacy 952 McDonald Avenue,Brooklyn,NY,11218,718-435-3100,718-435-1671
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- SPENCER DRUGS 5702 7TH AVENUE,Brooklyn,NY,11220,718-439-3852,718-439-3529
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- SQUARE DEAL PHARMACY 437 MOTHER GASTON BLVD.,Brooklyn,NY,11212,718-495-1414,718-495-1453
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- St Jude Pharmacy 121 st nicholas ave,Brooklyn,NY,11237,718-381-5116,718-417-3621
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- St Mary Pharmacy 9720 4th Ave,Brooklyn,NY,11209,718-921-2525,718-921-5432
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- St Marys Pharmacy 9720 4th Ave,Brooklyn,NY,11209,718-921-2525,718-921-5432
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- STARRETT CITY PHARMACY 1110 PENNSYLVANIA AVENUE,Brooklyn,NY,11207,718-257-8777,718-257-8884
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- Staywell Pharmacy 172 Watkins Street,Brooklyn,NY,11212,718-498-7800,718-498-7801
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- Stellas Pharmacy 8722 Glenwood Road,Brooklyn,NY,11236,718-272-8450,718-272-4279
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- STJRX / Thriftway Pharmacy 720 Classon Ave,Brooklyn,NY,11238,718-399-1800,718-399-2681
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- STOP & SHOP PHARMACY #505 1710 Avenue Y,Brooklyn,NY,11235,718-648-6971,718-368-0993
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- STUART SLATER PHARMACY 63 LEE AVE,Brooklyn,NY,11211,718-387-2852,718-388-4376
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- SUMNER AVE. PHARMACY 103 MARCUS GARVEY BLVD.,Brooklyn,NY,11206,718-455-7100,718-455-7102
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- Sunrise Pharmacy 6725 BAY PARKWAY,Brooklyn,NY,11204,718-837-0600,718-837-0140
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- SUNSHINE PHARMACY 411 KINGSTON AVENUE,Brooklyn,NY,11225,718-376-6563,718-376-6018
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- Sunshine Pharmacy, Inc. 1622 Voohries Avenue,Brooklyn,NY,11235,718-986-9086,718-260-4941
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- Super Value Drugs Brooklyn 2927 Ave S,Brooklyn,NY,11229,718-998-6200,718-998-6840
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- Sure Drugs 312 Ralph Ave,Brooklyn,NY,11233,718-774-6800,718-774-1776
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- Sut-Pen Pharmacy 629 Sutter Avenue,Brooklyn,NY,11207,718-498-8898,718-485-9026
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- SVRH Pharmacy 161 Smith St,Brooklyn,NY,11201,718-596-1688,718-237-6078
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- Swan Pharmacy, Inc. 650 Franklin Avenue,Brooklyn,NY,112033705,718-623-9633,718-623-9842
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- T & N Pharmacy, Inc. 2570 East 17 Street,Brooklyn,NY,11235,718-646-2100,718-646-2101
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- TARGET PHARMACY #1401 519 GATEWAY DRIVE,Brooklyn,NY,11239,718-235-7139,718-235-7139
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- TARGET PHARMACY #1849 139 FLATBUSH AVE,Brooklyn,NY,11217,718-290-1110,718-290-1110
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- TARGET PHARMACY #2212 2201 NOSTRAND AVE,Brooklyn,NY,11210,718-637-5006,718-637-5006
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- TEPS PHARMACY, INC. 1563 RALPH AVENUE,Brooklyn,NY,11236,718-676-0697,718-676-0759
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- The Polish American Pharmacy 566 Leonard St,Brooklyn,NY,11222,718-389-1500,718-389-1729
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- Theonis Pharmacy 306 86th St.,Brooklyn,NY,11209,718-836-7555,718-836-3111
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- THREE-P DRUGS 799 FLUSHING AVE,Brooklyn,NY,11206,718-302-4850,718-302-4851
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- Thriftway Church Ave 1621 Church Ave,Brooklyn,NY,11226,718-282-4600,718-282-3815
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- Thriftway Flatbush 542 Flatbush Ave,Brooklyn,NY,11225,718-284-9800,718-462-5303
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- Thriftway Foster Ave 1717 Foster Ave,Brooklyn,NY,11230,718-724-1717,718-859-4688
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- Thriftway Vanderveer 1887 Nostrand Ave,Brooklyn,NY,11226,718-282-2927,718-284-2284
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- Thriftway Washington 759 Washington Ave,Brooklyn,NY,11238,718-638-3800,718-638-0239
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- Tricare Pharmacy, Inc. 1807 Kings Highway,Brooklyn,NY,11229,718-382-9999,718-382-9988
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- U-15 PHARMACY 1501 AVE U,Brooklyn,NY,11229,718-336-5883,718-336-6936
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- UNITED PHARMACY 527 GRAND AVENUE,Brooklyn,NY,11211,718-384-7901,718-218-8591
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- Unity Drugs 772 Grand Street,Brooklyn,NY,11211,718-486-0344,718-486-0345
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- Unzer Pharmacy 572 bedford ave,Brooklyn,NY,11211,718-384-7334,718-599-5155
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- Utica Pharmacy 285-287 utica avenue,Brooklyn,NY,11213,718-953-7351,718-953-4968
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- V & A Pharmacy 72 Manhattan Avnue,Brooklyn,NY,11206,718-388-8500,718-388-8755
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- VAL-U-DRUGS 822 CLARKSON AVE,Brooklyn,NY,11203,718-773-5547,718-773-5568
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- Value Med Pharmacy 87 Avenue O,Brooklyn,NY,11204,718-232-7766,718-232-4004
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- VGH Pharmacy dba Myrtle Ave 1454 Myrtle Ave,Brooklyn,NY,11237,718-453-6200,718-455-3226
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- VLS Pharmacy 4402 Fifth Ave,Brooklyn,NY,11220,718-854-1384,718-854-4313
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- WALDBAUMS #70-240 2149 RALPH AVENUE,Brooklyn,NY,11234,718-531-7682,718-531-3852
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- Walgreen Drug Store #12541 1847 Rockaway Pkwy,Brooklyn,NY,11236,718-251-0426,718-251-2618
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- Walgreens Drug Store 5740 Ritchie Hwy,Brooklyn,NY,21225,410-789-2127,410-789-1827
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- Walgreens Drug Store 1404 Rockaway Pkwy,*NWC of Midblock Rockaway Parkway &,Brooklyn,NY,11236,718-257-2916,718-257-1720
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- Walgreens Drug Store 114 Beverley Rd.,Brooklyn,NY,112183914,718-437-7802,718-437-7808
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- Walgreens Drug Store 2101 Church Ave,Brooklyn,NY,112263909,718-469-7012,718-469-7018
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- Walgreens Drug Store 6628 18th Ave,Brooklyn,NY,112044314,718-236-6790,718-236-6796
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- Walgreens Drug Store 520 Atlantic Ave.,Brooklyn,NY,112171914,718-858-8562,718-858-0172
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- Walgreens Drug Store 5716 Avenue U,Brooklyn,NY,112345210,718-252-6350,718-258-8390
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- Walgreens Drug Store 713 Brighton Beach Ave,Brooklyn,NY,112356413,718-615-3103,718-769-1342
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- Walgreens Drug Store 379 Myrtle Ave,Brooklyn,NY,11205,718-403-9112,718-403-9118
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- Walgreens Drug Store 285 Kings Hwy,Brooklyn,NY,11223,718-339-6281,718-339-6287
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- Walgreens Drug Store 1405 Avenue J,Brooklyn,NY,112303701,718-677-7290,718-677-7296
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- Walgreens Drug Store 7002 13th Ave,Brooklyn,NY,11228,718-921-1896,718-238-1586
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- Walgreens Drug Store 210 Union Ave.,Brooklyn,NY,112116521,718-963-3130,718-963-3574
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- Walgreens Drug Store 532 Neptune Ave.,Brooklyn,NY,112244010,718-372-1551,718-372-0292
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- Walgreens Drug Store 3000 Church Ave.,Brooklyn,NY,112264210,718-564-2380,718-564-2386
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- Walgreens Drug Store 946 Kings Hwy.,Brooklyn,NY,112232338,718-645-2689,718-645-3173
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- Walgreens Drug Store 1366 Broadway,Brooklyn,NY,11221,718-452-6391,718-452-6397
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- Walgreens Drug Store 755 Broadway,Brooklyn,NY,112065320,718-963-2702,718-963-2769
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- Walgreens Drug Store 1721 Avenue U,Brooklyn,NY,112293811,718-645-2565,718-645-8271
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- Walgreens Drug Store #10441 2590 Coney Island Ave,Brooklyn,NY,11223,718-648-0120,718-648-0637
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- Walgreens Drug Store 12732 9408 Third Ave,Brooklyn,NY,11209,718-748-1673,718-748-1760
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- Welcare Drugstore Inc. 35 Graham Ave,Brooklyn,NY,11206,718-599-7200,718-599-3004
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- Welcome Pharmacy 1403 Foster Ave,Brooklyn,NY,11230,718-724-1333,718-724-2333
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- Wellens Pharmacy 295 Kings Highway,Brooklyn,NY,11223,718-382-4400,718-998-1764
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- Westside Pharmacy 210Ave U,Brooklyn,NY,11223,718-373-4100,718-373-4114
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- WILLEN PHARMACY 521 B MYRTLE AVE,Brooklyn,NY,11205,718-789-7055,718-789-7055
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- Williamsburg Pharmacy 244 Roebling Street,Brooklyn,NY,11211,718-387-9772,718-387-8291
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- Woodhul RX Center 751 Flushing Ave,Brooklyn,NY,11206,718-599-1309,718-599-1374
- <option value="69C9E0A7-7FF3-4637-979D-A5DE4798A4A5">
- Wyckoff Corner Pharmacy 205 Court St,Brooklyn,NY,11201,718-923-1122,718-923-9811
- <option value="668DD91E-6789-4410-8B2E-C742900FEE39">
- WYCKOFF PHARMACY 1236 BROADWAY,Brooklyn,NY,11221,718-443-1331,718-452-5930
- <option value="CD86CBBD-0D0F-4E67-9F11-422422323E69">
- Wyckoff Pharmacy, Inc. 131 Wyckoff Avenue,Brooklyn,NY,11237,718-381-6200,718-381-6201
- <option value="0714D2C4-742F-40B4-80CD-28FDF7FE87AF">
- Yafit Pharmacy 418 Ave U,Brooklyn,NY,11223,718-998-8651,718-998-7823
- <option value="AC056E4E-CDA2-4AD0-A8A6-15F266656C60">
- Zoya Pharmacy Inc. 1527 Pitkin Avenue,Brooklyn,NY,11212,718-342-3911,718-342-3988
- <option STYLE="background-color:#A4F4F4" value="E31BDFBA-17C3-42A4-80AE-4B2C293EFC12">
- Care Pharmacy 5915 Ave. N,Brooklyn,NY,11234,7182092222,7182099489
- <option STYLE="background-color:#A4F4F4" value="FB98F0EF-C474-43E7-A71F-4A446E6CAACB">
- CVS/pharmacy #0802 2320 RALPH AVENUE,BROOKLYN,NY,11234,7182098125,7182098127
- <option STYLE="background-color:#A4F4F4" value="360B8427-01C4-42F2-80B5-8DB3E005ABB7">
- CVS/pharmacy #1169 44 NORTH CENTRAL AVENUE,VALLEY STREAM,NY,11580,5165613401,5168728109
- <option STYLE="background-color:#A4F4F4" value="EF3C0353-FAB1-4AA1-90E2-9A618D0D3BFA">
- CVS/pharmacy #2400 1235 2ND AVENUE,NEW YORK,NY,10021,2127527703,2127529683
- <option STYLE="background-color:#A4F4F4" value="79DD2C94-E26B-472F-8DB4-2B6BAFA7EB65">
- CVS/pharmacy #2443 2120 ROCKAWAY PARKWAY,BROOKLYN,NY,11236,7182514158,7182516608
- <option STYLE="background-color:#A4F4F4" value="70707359-B95C-43FF-93E4-5CA6FDCDFFF6">
- CVS/pharmacy #2720 88-07 ROCKAWAY BEACH BLVD.,ROCKAWAY BEACH,NY,11693,7183182700,7183182802
- <option STYLE="background-color:#A4F4F4" value="BC934BAC-A52D-443D-BE09-02C8E1370000">
- CVS/pharmacy #2769 4901 KINGS HIGHWAY,BROOKLYN,NY,11234,7182527170,7182528208
- <option STYLE="background-color:#A4F4F4" value="6A5DF0E9-289C-4502-8C47-E971791DFE01">
- CVS/pharmacy #2906 10204 FLATLANDS AVE.,BROOKLYN,NY,11236,7182574993,7182575110
- <option STYLE="background-color:#A4F4F4" value="342B606C-A018-4F11-B99A-EA25FB4F5CA1">
- CVS/pharmacy #5370 1 EAST MERRICK RD,VALLEY STREAM,NY,11580,5165680792,5165682782
- <option STYLE="background-color:#A4F4F4" value="AD21A16E-B863-4DAD-8C64-12B631DF3CC3">
- DUANE READE #125 67 BROAD STREET,NEW YORK,NY,10004,2129433690,2124251945
- <option STYLE="background-color:#A4F4F4" value="D1215B4D-65B3-438E-A6CE-7FC43ACF550D">
- DUANE READE #206 113-03 BEACH CHANNEL DR,FAR ROCKAWAY,NY,11694,7189457781,
- <option STYLE="background-color:#A4F4F4" value="D4327656-6F16-4726-9CE7-DB9AB9C1F67F">
- DUANE READE #241 1082 2ND AVENUE,NEW YORK,NY,10022,2122231130,2122232092
- <option STYLE="background-color:#A4F4F4" value="26B823DB-90AC-43F1-870F-F98D7424A9BB">
- DUANE READE #294 2141-45 NOSTRAND AVE,BROOKLYN,NY,11210,7184341211,7188596751
- <option STYLE="background-color:#A4F4F4" value="41FC4AB1-FE43-4B0C-817E-E1BFFE13E205">
- DUANE READE #349 750 NEW YORK AVE,BROOKLYN,NY,11203,7189418694,7189416549
- <option STYLE="background-color:#A4F4F4" value="4C125F19-5BC9-454E-8C01-FA9A320C7228">
- DUANE READE #444 2265 RALPH AVENUE,BROOKLYN,NY,11234,7182413700,
- <option STYLE="background-color:#A4F4F4" value="2DC415DF-F05A-4106-B72F-A2E248DF95A1">
- Global United Pharmacy, Inc. 179-42 Hillside Avenue,Jamaica,NY,11432,7182060271,7182060254
- <option STYLE="background-color:#A4F4F4" value="C8A26E21-8FF3-4B69-9321-80DAEBC847C9">
- KINGSWAY PHARMACY 1425 KINGS HWY,BROOKLYN,NY,11229,7183827700,7186458655
- <option STYLE="background-color:#A4F4F4" value="49825CB5-8854-4BA1-AB5C-AF41CBAB251C">
- Marcy Pharmacy 170 Throop Avenue,Brooklyn,NY,11206,7183845917,
- <option STYLE="background-color:#A4F4F4" value="E8D3FFB0-24B7-48BA-B231-4D2E8C6FD4BE">
- Ocean Pharmacy #2 915 E 107th Street,Brooklyn,NY,11236,7182722282,7182722676
- <option STYLE="background-color:#A4F4F4" value="EB36CF93-703C-4D54-AEE9-F24C20F2D843">
- PATHMARK #72-634 11110 FLATLANDS AVE,BROOKLYN,NY,11207,7186492522,8775615029
- <option STYLE="background-color:#A4F4F4" value="3A16DA88-682D-4A3D-AE7B-3465D4D322B8">
- RITE AID- 1631-43 PITKIN AVE 1631-43 PITKIN AVENUE,BROOKLYN,NY,112125050,7184989530,7189229871
- <option STYLE="background-color:#A4F4F4" value="E032BCB8-2832-4FDF-84B7-D8699F922E7F">
- RITE AID-1040 ST JOHNS PLACE 1040 SAINT JOHNS PLACE,BROOKLYN,NY,112132533,7189537150,7187788467
- <option STYLE="background-color:#A4F4F4" value="9F7DE993-DCAA-46B2-9DC5-779DD22C2365">
- RITE AID-10640 ROCKAWAY BEACH 10640 ROCKAWAY BEACH BLVD,ROCKAWAY PARK,NY,116941169,7183188512,7183188517
- <option STYLE="background-color:#A4F4F4" value="53EB7849-6252-4FA7-A81D-A70FA806A313">
- RITE AID-1380 ROCKAWAY PKWY 1380 ROCKAWAY PARKWAY,BROOKLYN,NY,112362322,7182721107,7185667562
- <option STYLE="background-color:#A4F4F4" value="4183F782-2474-4864-87D6-9C8DBEEB8A58">
- RITE AID-1559 FLATBUSH AVE 1559 FLATBUSH AVENUE,BROOKLYN,NY,112103041,7184345755,
- <option STYLE="background-color:#A4F4F4" value="86060DCB-F2C5-4E3B-8001-389843916539">
- RITE AID-1791 UTICA AVE 1791 UTICA AVENUE,BROOKLYN,NY,112342120,7182413559,7184513537
- <option STYLE="background-color:#A4F4F4" value="65691141-BC95-4310-A68C-B9044DABB9C7">
- RITE AID-2064 MILL AVENUE 2064 MILL AVENUE,BROOKLYN,NY,112345922,7185310408,7185312986
- <option STYLE="background-color:#A4F4F4" value="B66F5EF6-9133-46F6-A124-0158CF0E3AA0">
- RITE AID-222-14 LINDEN BLVD. 222-14 LINDEN BOULEVARD,CAMBRIA HEIGHTS,NY,114111606,7189493000,
- <option STYLE="background-color:#A4F4F4" value="4671559D-F586-413F-9C5C-E07ADD36B88B">
- RITE AID-3199 LONG BEACH ROAD 3199 LONG BEACH ROAD,OCEANSIDE,NY,115724107,5167667200,5167631426
- <option STYLE="background-color:#A4F4F4" value="6ABB51AC-43DD-417C-8C6D-28B599D9B01D">
- RITE AID-4102 CHURCH AVE. 4102 CHURCH AVENUE,BROOKLYN,NY,112033006,7189401579,7184697283
- <option STYLE="background-color:#A4F4F4" value="302F9CBD-D931-40A9-BCA9-2621C8E74FAA">
- Walgreen Drug Store #12541 1847 Rockaway Pkwy,Brooklyn,NY,11236,7182510426,7182512618
- <option STYLE="background-color:#A4F4F4" value="63F9B85A-4098-468F-ABAB-50121478AC33">
- Walgreens Drug Store 12704 Guy R. Brewer Blvd.,Jamaica,NY,114342955,7189784458,7189784485
- <option STYLE="background-color:#A4F4F4" value="B260BA09-0036-4BC5-A7F2-A3955AE1B801">
- Walgreens Drug Store #10441 2590 Coney Island Ave,Brooklyn,NY,11223,7186480120,7186480637
- <option STYLE="background-color:#A4F4F4" value="9E398411-229A-452D-8ABA-9109F206C303">
- Walgreens Drug Store 11807 5001 Church Ave,Brooklyn,NY,11203,3475570959,3475570965
- <option STYLE="background-color:#A4F4F4" value="9F185963-07BC-495E-9A8E-AB8C0D20DA47">
- Walgreens Drug Store 11808 4915 Flatlands Ave,Brooklyn,NY,11234,3478565852,3478565858
- </select>
- <input type="button" value="Other e-Pharmacy" onclick="addSSPharmacy()">
- <DIV id=PharmacyNameDiv style="visibility:hidden;display:none;position:absolute;z-index:110;border:1px solid black;background-color:#FFFDF5"></div>
- </td>
- </tr>
- <tr class=hidePortal>
- <TD nowrap>Disable Health Alerts</TD>
- <TD><input type=CheckBox name="disableAlert" value="1" ></TD>
- </TR>
- <tr class=hidePortal>
- <TD>External Rec#<span id="astrickExternalRec"></TD>
- <TD>
- <input tabIndex=117 type=text size=10 name="externalPatientId" value="" size=25>
- NPI <input tabIndex=118 type=text maxLength="64" size=10 name="patientNationalIdentifier" value="">
- </TD>
- </TR>
- <tr class=hidePortal>
- <TD nowrap>Treatment Status</TD>
- <TD><SELECT tabIndex=119 name="patientDetailsAttrib">
- <option value"0">
- <option value="1">Pending Insurance Certification
- <option value="2">Patient Availability
- <option value="4">Pending (Other)
- <option value="8">In Treatment
- <option value="16">Discharged (Healed)
- <option value="32">Discharged (Amputated)
- <option value="64">Discharged (Treatment Aborted)
- <option value="128">Discharged (Never Treated)
- <option value="256">Discharged (Healing/Improved)
- <option value="512">Discharged (Died)
- <option value="1024">Discharged (No Improvement)
- <option value="2048">Inactive
- </SELECT></TD>
- </TR>
- <TR class=hidePortal>
- <TD nowrap>Custom Field1 </TD>
- <TD width=230 colspan=3><input tabIndex=120 size=10 type="TEXT" maxLength="255" name="customField1" value="" maxLength="128" ></TD>
- </TR>
- <TR class=hidePortal>
- <TD width=130>Custom Field2 </TD>
- <TD width=230 colspan=3><input tabIndex=122 size=10 type="TEXT" maxLength="255" name="customField2" value="" maxLength="128" ></TD>
- </TR>
- <!-- added on 200509 by siddharth -->
- <input type="hidden" name="generatePS" value="1" />
- <TR class=hidePortal>
- <TD width=130>Exemption from Reporting</TD>
- <TD width=230 colspan=3>
- <input type=radio name=reportExempt value="1" style='border:0px;' >Yes
- <input type=radio name=reportExempt value="0" CHECKED style='border:0px;' >No
- </TD>
- </TR>
- <tr class=hideprotal>
- <TD>Patient Reminder </TD>
- <TD><select name="patientReminder"><option value="">--- Select ---</option>
- <option value="No Reminder">No Reminder
- <option value="By E-mail">By E-mail
- <option value="By Mail">By Mail
- <option value="By Phone">By Phone
- <option value="By SMS">By SMS</select> </TD>
- </tr>
- <TR class=hidePortal>
- <TD>Comments</TD>
- <TD width=230 colspan=3>
- <TEXTAREA cols=28 rows=3 name="comments" > </TEXTAREA>
- </TD>
- </TR>
- <!-- END BY SUGAM ON 13/8/2010 -->
- <!-- Added By Vimal On 29/12/2010 -->
- <tr class=hidePortal>
- <TD nowrap>No Known Problems</TD>
- <TD><input type=CheckBox name="noKnownProblem" value="1" ></TD>
- </TR>
- <!-- Ended By Vimal -->
- <TR>
- <td></td>
- <td><input type="hidden" name="clinicCode" value="3412"></td>
- </TR>
- <tr background="red">
- <td nowrap>MU Demographic Exclusion</td>
- <td><select name="muDemographicExclusion" onclick="javascript:checkReqField(this)" onchange='javascript:createTextBox(this);'>
- <option value="">--- Select ---</option>
- <option value="Patient Declined">Patient Declined</option>
- <option value="Contrary to State Law">Contrary to State Law</option>
- <option value="Other" >Other</option>
- </select>
- <input type="text" name="muDemographicExclusionOther" style="visibility:hidden;" id="muDemographicExclusionOther" value="">
- </td>
- </tr>
- <tr>
- </tr>
- </TABLE>
- </td>
- </tr>
- <tr ><td nowrap colspan=2><br><b style="color:red;">The highlighted items are key to meaningful use criteria. Please select them as applicable.</b></td></tr>
- <tr><td colspan=2 align=center>
- <br>
- <INPUT tabIndex=126 type="button" NAME="btnSave" id="btnSave" VALUE=" Save " onClick="preValidateContent(this)"> <INPUT tabIndex=128 type="button" NAME="saveAndAddIns" id="saveAndAddIns" VALUE=" Save & Add Insurance " onClick="preValidateContent(this),setURL()"> <INPUT TYPE=Button tabIndex=130 NAME=CANCEL VALUE=" Cancel " OnClick="javascript:history.back()">
- <!-- <INPUT tabIndex=126 TYPE=SUBMIT NAME=SUBMIT VALUE=" Save " onClick="selectedEmployer(),selectedAttorney()"> <INPUT tabIndex=128 TYPE=SUBMIT NAME=SUBMIT VALUE=" Save & Add Insurance " onClick="setURL(),selectedEmployer(),selectedAttorney()"> <INPUT TYPE=Button tabIndex=130 NAME=CANCEL VALUE=" Cancel " OnClick="javascript:history.back()">-->
- </td></tr>
- </table>
- </Form>
- </TD>
- </TR>
- </TABLE>
- <script src="/jsp/Formvalidate.js"></script>
- <script src="/jsp/dateFunctions.js"></script>
- <script>
- function showDropDownBox(Selection) {
- var phonevalue;
- if (document.AddEditForm.preferredPhoneNo.options[document.AddEditForm.preferredPhoneNo.selectedIndex].value == "HomePhone") {
- document.AddEditForm.phonevalue.value = "HomePhone";
- }else if (document.AddEditForm.preferredPhoneNo.options[document.AddEditForm.preferredPhoneNo.selectedIndex].value == "WorkPhone") {
- document.AddEditForm.phonevalue.value = "WorkPhone";
- }else {
- document.AddEditForm.phonevalue.value = "CellPhone";
- }
- //alert(document.AddEditForm.phonevalue.value);
- }
- </script>
- <script language="javascript">
- document.AddEditForm.dateOfBirth.value="01/30/1988";
- function setURL()
- {
- var patientLoginFlag="";
- return;
- }
- function preValidateContent(obj){
- if(obj.value==" Save & Add Insurance "){
- setURL();
- AddEditForm.SUBMIT.value="";
- }else{
- AddEditForm.SUBMIT.value="Save";
- }
- validateContent();
- }
- function validateContent(){
- var error="";
- var isError=false;
- var loginDoctorRole ="Assistant";
- var patientLoginFlag="";
- if(patientLoginFlag=="true" || loginDoctorRole=="Portal"){
- error+=check("username","User Name",MANDATORY,TEXT);
- error+=check("password","Password",MANDATORY,TEXT);
- error+=check("confirmPassword","Confirm Password",MANDATORY,TEXT);
- var portalError="";
- var userValue=document.AddEditForm.username.value;
- var passValue=document.AddEditForm.password.value;
- var conPassValue=document.AddEditForm.confirmPassword.value;
- if(userValue.length >16)
- {
- portalError+="Please enter the user code less than 16 characters.\n";
- }
- //error+=check("externalPatientId","External Rec#",MANDATORY,TEXT);
- if(userValue.indexOf(" ")!=-1)
- {
- portalError+="Spaces are not allowed in User Code.\n";
- }
- if((passValue.length < 6 )|| (passValue.length >16))
- {
- portalError+="Please enter the password more than 6 characters but less than 16 characters.\n";
- }
- if((conPassValue.length < 6 )|| (conPassValue.length >16))
- {
- portalError+="Please enter the Retype password more than 6 characters but less than 16 characters.\n";
- }
- if(document.AddEditForm.password.value!=document.AddEditForm.confirmPassword.value){
- portalError+="Password and Retype Password do not Match.\n";
- }
- if(userValue==passValue)
- {
- portalError+="User Code and Password can not be same.\n";
- }
- if(portalError.length>0)
- {
- alert(portalError);
- return false;
- }
- }
- if(bNameChanged){
- if(document.AddEditForm.nameChangeEffect[0].checked) document.AddEditForm.nameChangeType.value="all";
- if(document.AddEditForm.nameChangeEffect[1].checked) document.AddEditForm.nameChangeType.value="new";
- error+=check("nameChangeType","Name Change/Correction option",MANDATORY,TEXT);
- }
- //document.AddEditForm.dateOfBirth.value=document.AddEditForm.dateOfBirth_month[document.AddEditForm.dateOfBirth_month.selectedIndex].value+"/"+document.AddEditForm.dateOfBirth_day[document.AddEditForm.dateOfBirth_day.selectedIndex].value+"/"+document.AddEditForm.dateOfBirth_year[document.AddEditForm.dateOfBirth_year.selectedIndex].value;
- phonevalue=document.AddEditForm.preferredPhoneNo.value;
- error+=check("firstName","First Name",MANDATORY,TEXT);
- error+=check("lastName","Last Name",MANDATORY,TEXT);
- error+=check("address1","Address Line 1",MANDATORY,TEXT);
- if(document.AddEditForm.firstName.value.length > 25)
- error+= " First Name should not be longer than 25 characters\n";
- if(document.AddEditForm.lastName.value.length > 35)
- error+= " Last Name should not be longer than 35 characters\n";
- if(document.AddEditForm.middleInital.value.length > 25)
- error+= " Middle Initial should not be longer than 25 characters\n";
- if(document.AddEditForm.address1.value.length > 35)
- error+= " Address Line 1 should not be longer than 25 characters\n";
- if(document.AddEditForm.address2.value.length > 35)
- error+= " Address Line 2 should not be longer than 25 characters\n";
- if(document.AddEditForm.city.value.length > 25)
- error+= " City should not be longer than 25 characters\n";
- error+=validateSSN(document.AddEditForm.ssn.value);
- //error+=check("ssn","SSN",MANDATORY,TEXT);
- error+=check("dateOfBirth","Date Of Birth",MANDATORY,DATE);
- error+=check("gender","Gender",MANDATORY,TEXT);
- error+=check("city","City",MANDATORY,TEXT);
- //error+=check("homePhone","Home Phone",MANDATORY,TEXT);
- //error+=check("preferredPhoneNo","Preferred Phone No",MANDATORY,TEXT);
- //error+=check(phonevalue,phonevalue,MANDATORY,TEXT);
- var zip = document.AddEditForm.zipCode.value;
- if(zip.length > 0){
- var valid = "0123456789-";
- var hyphencount = 0;
- if (zip.length!=5 && zip.length!=10) {
- error+="Please enter your 5 digit or 5 digit+4 zip code.";
- }
- for (var i=0; i < zip.length; i++) {
- temp = "" + zip.substring(i, i+1);
- if (temp == "-") hyphencount++;
- if (valid.indexOf(temp) == "-1") {
- error+="Invalid characters in your zip code. Please try again.";
- break;
- }
- if ((hyphencount > 1) || ((zip.length==10) && ""+zip.charAt(5)!="-")) {
- error+="The hyphen character should be used with a properly formatted 5 digit+four zip code, like '12345-6789'. Please try again.";
- break;
- }
- }
- }
- if(document.AddEditForm.homePhone.value.length > 25)
- error+= "Home Phone should not be longer than 25 characters\n";
- if(document.AddEditForm.workPhone.value.length > 25)
- error+= "Work Phone should not be longer than 25 characters\n";
- if(document.AddEditForm.cellPhone.value.length > 25)
- error+= "Cell Phone should not be longer than 25 characters\n";
- if(!isInteger(document.AddEditForm.homePhoneExt.value))
- error+= "Home Phone ext must be numeric\n";
- if(!isInteger(document.AddEditForm.workPhoneExt.value))
- error+= "Work Phone ext must be numeric\n";
- if(document.AddEditForm.email.value.length > 85)
- error+= "E-mail Address should not be longer than 85 characters\n";
- if(document.AddEditForm.emergencyContact1.value.length > 128)
- error+= "Emergency Contact1 should not be longer than 128 characters\n";
- if(document.AddEditForm.emergencyContact2.value.length > 128)
- error+= "Emergency Contact2 should not be longer than 128 characters\n";
- /*
- if(zip.length > 0){
- var zeroPos = "valid";
- if(zip.charAt(0) == '0')
- error+=" \n Zip code can't contain 0 at first position."
- }
- */
- error+=check("email","Email",NONMANDATORY,EMAIL);
- error+=check("signatureOnFile","Signature on File",NONMANDATORY,DATE);
- error+=check("releaseOfInfoSigned","Release of Info Signed",NONMANDATORY,DATE);
- var preferenceorder = document.AddEditForm.callPreferenceOrder.value;
- if(phonevalue=="WorkPhone"){
- if( preferenceorder.charAt(0)!="W" && preferenceorder.charAt(0)!="D" )
- error+= "First option in call preference order should be preferred phone.\n";
- }
- if(phonevalue=="HomePhone"){
- if(preferenceorder.charAt(0)!="H" && preferenceorder.charAt(0)!="D" )
- error+="First option in call preference order should be preferred phone.\n";
- }
- if(phonevalue=="CellPhone"){
- if(preferenceorder.charAt(0)!="C" && preferenceorder.charAt(0)!="D" )
- error+="First option in call preference order should be preferred phone.\n";
- }
- var externalRecNo = document.AddEditForm.externalPatientId.value;
- if(externalRecNo.length > 64)
- error+="External Rec# must be less than 64 characters\n";
- var patientDOB=document.AddEditForm.dateOfBirth.value;
- if(patientDOB.substring(6,10)<1900){
- error+="Year in Date of Birth Must be equal or greater than 1900.\n";
- }
- //error+=check("externalPatientId","External Rec#",MANDATORY,TEXT);
- var patFieldsMandatory = "No";
- if(patFieldsMandatory!=""){
- if(patFieldsMandatory.indexOf("Middle Initial")!=-1){
- error+=check("middleInital","Middle Initial",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Race")!=-1){
- error+=check("racedescription","Race",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Ethnicity")!=-1){
- error+=check("ethnicity","Ethnicity",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Smoker")!=-1){
- error+=check("smoker","Smoker",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Preferred Language")!=-1){
- error+=check("preferredLanguage","Preferred Language",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("SSN")!=-1){
- error+=check("ssn","SSN",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Guardian")!=-1){
- error+=check("guardian","Guardian Name",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Work Status")!=-1){
- error+=check("workStatus","Work Status",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Occupation")!=-1){
- error+=check("occupation","Occupation",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Attorney")!=-1){
- error+=check("attorney","Attorney",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Student Status")!=-1){
- error+=check("studentStatus","Student Status",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Referring Doctor")!=-1){
- error+=check("referringDoctorName","Referring Doctor Name",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("State")!=-1){
- error+=check("state","State",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Zip Code")!=-1){
- error+=check("zipCode","Zip Code",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Country")!=-1){
- error+=check("country","Country",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("HomePhone")!=-1){
- error+=check("homePhone","Home Phone",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("WorkPhone")!=-1){
- error+=check("workPhone","Work Phone",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("EmergencyContact1")!=-1){
- error+=check("emergencyContact1","EmergencyContact1",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("Employer")!=-1){
- error+=check("company","Employer",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("E-mail")!=-1){
- error+=check("email","E-mail",MANDATORY,TEXT);
- }if(patFieldsMandatory.indexOf("External Rec")!=-1){
- error+=check("externalPatientId","External Rec#",MANDATORY,TEXT);
- }
- }
- if(AddEditForm.isCustomFieldMandatory!=null){
- if(AddEditForm.isCustomFieldMandatory.length>=2)
- {
- for (var i=0;i<AddEditForm.isCustomFieldMandatory.length;i++)
- {
- isError = false;
- if (AddEditForm.isCustomFieldMandatory[i].value == "1" && trim(AddEditForm.customFields[i].value) == "")
- {
- isError = true;
- //alert(AddEditForm.labelName[i].value + " is mandatory.");
- AddEditForm.customFields[i].focus();
- }
- if(isError)
- {
- error+=AddEditForm.labelName[i].value + " is mandatory.\n";
- }
- }
- }
- else
- {
- if (AddEditForm.isCustomFieldMandatory.value == "1" && trim(AddEditForm.customFields.value) == "")
- {
- error+=AddEditForm.labelName.value + " is mandatory.\n";
- //alert(AddEditForm.labelName.value + " is mandatory.");
- AddEditForm.customFields.focus();
- }
- }
- }
- if(error.length>0)
- {
- alert(error);
- return false;
- }else{
- if("Edit"=="Add"){
- document.AddEditForm.action="/servlet/PatientController?action=AddSubmit";
- }else{
- document.AddEditForm.action="/servlet/PatientController?action=EditSubmit";
- }
- if(document.AddEditForm.employerId.value == "")
- document.AddEditForm.company.value=document.AddEditForm.employername.value;
- else
- document.AddEditForm.company.value=document.AddEditForm.employername.value;
- // Added by chintan
- if((document.AddEditForm.dateOfBirth.value=="" || document.AddEditForm.preferredLanguage.value=="" || document.AddEditForm.ethnicity.value=="" || document.AddEditForm.smoker.value=="" || document.AddEditForm.racedescription.value=="") && document.AddEditForm.muDemographicExclusion.value==""){
- if(confirm("As a part of meaningful use, you are required to capture the following information from the patient\'s demographic page. If you decide not to capture this information you can hit the \"Cancel\" button and this patient will be excluded from meaningful use reporting. \n\n - DOB\n - Gender\n - Race\n - Ethnicity\n - Smoker\n - Preferred Language\n ")==true){
- return;
- }
- }
- // Ended by chintan
- document.AddEditForm.submit();
- }
- }
- function validateSSN(ssn){
- ssn=trim(ssn);
- //if(ssn.length==0)return "SSN is mandatory\n";
- //if(ssn.length!=11)return "Invalid SSN \n";
- if(ssn.length!=0)
- {
- if(ssn.charAt(3)!="-")return "Invalid SSN \n";
- if(ssn.charAt(6)!="-")return "Invalid SSN \n";
- for (var i=0;i<10;i++ ){
- if((i==3)||(i==6))continue;
- if(!isInteger(ssn.charAt(i)))return "Invalid SSN \n";
- }
- }
- return "";
- }
- </script>
- <script>
- function selectedReferredByDoctorName(){
- document.AddEditForm.referredByDoctorName.value=document.AddEditForm.referredByDoctorId.options[document.AddEditForm.referredByDoctorId.selectedIndex].text;
- }
- mandatoryFont();
- function mandatoryFont(){
- var patFieldsMandatory = "No";
- var astSign="<font color='red'>*</font>";
- if(patFieldsMandatory!=""){
- if(patFieldsMandatory.indexOf("Middle Initial")!=-1){
- astrick2.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("SSN")!=-1){
- astrick5.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Guardian")!=-1){
- astrick1.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Work Status")!=-1){
- astrick3.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Occupation")!=-1){
- astrick4.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Attorney")!=-1){
- astrick6.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Race")!=-1){
- astrickRace.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Ethnicity")!=-1){
- astrickEthnicity.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Smoker")!=-1){
- astrickSmoker.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Preferred Language")!=-1){
- astrickPrimLan.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Student Status")!=-1){
- astrick7.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Referring Doctor")!=-1){
- astrick8.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("State")!=-1){
- astrick10.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Zip Code")!=-1){
- astrick11.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Country")!=-1){
- astrick12.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("HomePhone")!=-1){
- astrick15.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("WorkPhone")!=-1){
- astrick13.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("EmergencyContact1")!=-1){
- astrick14.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("Employer")!=-1){
- astrickEmployer.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("E-mail")!=-1){
- astrickEmail.innerHTML=astSign;
- }if(patFieldsMandatory.indexOf("External Rec")!=-1){
- astrickExternalRec.innerHTML=astSign;
- }
- }
- }
- function chkIt(fldVal)
- {
- if(fldVal=="") return;
- var validChars = "0123456789-";
- var i = 0;
- var isCaught = false;
- if(fldVal.length == 11)
- for (i = 0; i < fldVal.length; i++)
- if (validChars.indexOf(fldVal.charAt(i) ) == -1)
- isCaught = true;
- if (isCaught)
- {
- alert("Invalid SSN.");
- document.AddEditForm.ssn.focus();
- }
- var matchArr = fldVal.match(/^(\d{3})-?\d{2}-?\d{4}$/);
- var numDashes = fldVal.split('-').length - 1;
- if (matchArr == null || numDashes == 1) {
- alert('Invalid SSN. Must be 9 digits and in the format ###-##-####.\nOr leave the field blank to skip validation.');
- document.AddEditForm.ssn.focus();
- }
- else if (parseInt(matchArr[1],10)==0) {
- alert("Invalid SSN: SSN can't start with 000.");
- document.AddEditForm.ssn.focus();
- }
- }
- function maskIt(fldVal)
- {
- var validNum = "0123456789";
- var len = fldVal.length;
- // var keyEntered = fldVal.substring(len-1,len);
- if (event.keyCode < 45 || event.keyCode > 57 ) event.returnValue = false;
- if (event.keyCode == 45 ) event.returnValue = false;
- //if (validNum.indexOf(keyEntered ) == 58)
- // alert("You have entered a non-numeric character.\nPlease backspace and enter a number.");
- // len++;
- switch (len)
- {
- case 3:
- document.AddEditForm.ssn.value += "-";
- break;
- case 6:
- document.AddEditForm.ssn.value += "-" ;
- break;
- }
- }
- function changeCase(frmObj) {
- var index;
- var tmpStr;
- var tmpChar;
- var preString;
- var postString;
- var strlen;
- tmpStr = frmObj.value;
- strLen = tmpStr.length;
- if (strLen > 0) {
- for (index = 0; index < strLen; index++) {
- if (index == 0) {
- tmpChar = tmpStr.substring(0,1).toUpperCase();
- postString = tmpStr.substring(1,strLen);
- tmpStr = tmpChar + postString;
- }
- else {
- tmpChar = tmpStr.substring(index, index+1);
- if (tmpChar == " " && index < (strLen-1)) {
- tmpChar = tmpStr.substring(index+1, index+2).toUpperCase();
- preString = tmpStr.substring(0, index+1);
- postString = tmpStr.substring(index+2,strLen);
- tmpStr = preString + tmpChar + postString;
- }
- }
- }
- }
- frmObj.value = tmpStr;
- }
- var bNameChanged=false;
- function checkNameChange(frm){
- if(frm.firstName.value!=frm.firstNameOld.value || frm.lastName.value!=frm.lastNameOld.value || frm.middleInital.value!=frm.middleInitalOld.value){
- bNameChanged=true;
- document.all["trNameChange"].style.visibility="visible";
- document.all["trNameChange"].style.display="block";
- }else{
- bNameChanged=false;
- document.all["trNameChange"].style.visibility="hidden";
- document.all["trNameChange"].style.display="none";
- }
- }
- /*****
- function selectDoctor(formName)
- {
- window.open("/servlet/DoctorController?action=ReferredDoctorLookUp&toSync=1&formName="+formName,"","toolbar=no,width=350,height=300,scrollbars=yes")
- }
- function addDoctor(doctorId,firstName,lastName,formName)
- {
- setValue("referringDoctorName",firstName+" "+lastName,"TEXT",formName);
- setValue("referringDoctorId",doctorId,"TEXT",formName);
- }
- ****/
- var whichDoctor = "";
- function selectRefDoctor(formName)
- {
- var lastNameStart= eval("document."+formName+".referringDoctorName").value;
- whichDoctor = "REFDOC1"
- window.open("/servlet/DoctorController?action=ReferredDoctorLookUp&isPatientAddEdit=true&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart,"","toolbar=no,width=350,height=300,scrollbars=yes")
- }
- function selectAddnRefDoctor(formName)
- {
- var lastNameStart= eval("document."+formName+".additionalReferredByDoctorName").value;
- whichDoctor = "REFDOC2"
- window.open("/servlet/DoctorController?action=ReferredDoctorLookUp&isPatientAddEdit=true&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart,"","toolbar=no,width=350,height=300,scrollbars=yes")
- }
- function selectPriCareDoctor(formName)
- {
- var lastNameStart= eval("document."+formName+".primaryCarePhysician").value;
- whichDoctor = "PRICARE"
- window.open("/servlet/DoctorController?action=ReferredDoctorLookUp&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart,"","toolbar=no,width=350,height=300,scrollbars=yes")
- }
- function selectVNA(formName)
- {
- var lastNameStart= eval("document."+formName+".vnaName").value;
- whichDoctor = "VNADOC"
- window.open("/servlet/DoctorController?action=ReferredDoctorLookUp&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart,"","toolbar=no,width=350,height=300,scrollbars=yes")
- }
- function selectAttorney(formName)
- {
- var lastNameStart= eval("document."+formName+".attorney").value;
- whichDoctor = "ATTORNEY"
- // window.open("/servlet/AttorneyController?action=AttorneyLookUp&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart,"","toolbar=no,width=350,height=300,scrollbars=yes")
- window.open("/servlet/DoctorController?action=ReferredDoctorLookUp&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart+"&whichDoctor="+whichDoctor,"","toolbar=no,width=350,height=300,scrollbars=yes")
- }
- function selectAdjuster(formName)
- {
- var lastNameStart= eval("document."+formName+".adjuster").value;
- whichDoctor = "ADJUSTER"
- // window.open("/servlet/AttorneyController?action=AttorneyLookUp&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart,"","toolbar=no,width=350,height=300,scrollbars=yes")
- window.open("/servlet/DoctorController?action=ReferredDoctorLookUp&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart+"&whichDoctor="+whichDoctor,"","toolbar=no,width=350,height=300,scrollbars=yes")
- }
- function selectEmployer(formName)
- {
- whichDoctor = "EMPLOYER"
- var lastNameStart= eval("document."+formName+".employername").value;
- // window.open("/servlet/PatientController?action=EmployerLookUp&toSync=1&formName="+formName,"","toolbar=no,width=350,height=300,scrollbars=yes")
- window.open("/servlet/DoctorController?action=ReferredDoctorLookUp&toSync=1&formName="+formName+"&lastNameStart="+lastNameStart+"&whichDoctor="+whichDoctor,"","toolbar=no,width=350,height=300,scrollbars=yes")
- }
- function addDoctor(doctorId,firstName,lastName,formName)
- {
- if(whichDoctor=="ATTORNEY"){
- document.AddEditForm.attorney.value=firstName;
- setValue("attorneyId",doctorId,"TEXT",formName);
- }
- if(whichDoctor=="ADJUSTER"){
- document.AddEditForm.adjuster.value=firstName;
- setValue("adjusterId",doctorId,"TEXT",formName);
- }
- if(whichDoctor=="EMPLOYER"){
- document.AddEditForm.employername.value=firstName;
- setValue("employerId", doctorId, "TEXT", formName);
- setValue("employername", lastName+' '+firstName, "TEXT", formName);
- setValue("company", lastName+' '+firstName, "TEXT", formName);
- }
- if(whichDoctor=="REFDOC1"){
- setValue("referringDoctorName",firstName+" "+lastName,"TEXT",formName);
- setValue("referringDoctorId",doctorId,"TEXT",formName);
- }
- if(whichDoctor=="REFDOC2"){
- setValue("additionalReferredByDoctorName",firstName+" "+lastName,"TEXT",formName);
- setValue("additionalReferredByDoctorId",doctorId,"TEXT",formName);
- }
- if(whichDoctor=="PRICARE"){
- setValue("primaryCarePhysician",firstName+" "+lastName,"TEXT",formName);
- setValue("pcpDoctorId",doctorId,"TEXT",formName);
- }
- if(whichDoctor=="VNADOC"){
- setValue("vnaName",firstName+" "+lastName,"TEXT",formName);
- setValue("vnaDoctorId",doctorId,"TEXT",formName);
- }
- whichDoctor = "";
- }
- setValue("siteId","C7792C05-AA05-4D93-B029-959ABB26E955","SELECT","AddEditForm");
- </script>
- <script>
- //selectedEmployer();
- function showPharmacy(obj)
- {
- var str=obj.options[obj.selectedIndex].text;
- if(obj.options[obj.selectedIndex].value==""){
- closePharmacy();
- return;
- }
- PharmacyNameDivId=document.all("PharmacyNameDiv");
- PharmacyNameDivId.innerHTML=str+" <a href=#12 onClick='javascript:closePharmacy()' align=right>[X]</a>";
- PharmacyNameDivId.style.visibility = "visible";
- PharmacyNameDivId.style.display = "block";
- }
- function closePharmacy()
- {
- PharmacyNameDivIds=document.all("PharmacyNameDiv");
- PharmacyNameDivIds.innerText="";
- PharmacyNameDivIds.style.visibility ="hidden";
- PharmacyNameDivIds.style.display ="none";
- return false;
- }
- function setRaceDetails(raceid,racedesc,value){
- AddEditForm.racedescription.value=racedesc;
- AddEditForm.race.value=raceid;
- }
- function searchRace(formname){
- // document.AddEditForm.racedescr.value="";
- window.open("/servlet/PatientController?action=SearchRace&source="+formname+"&racedescr=","","toolbar=no,location=no,width=430,height=400,top=50,scrollbars=yes")
- }
- function addSSPharmacy(){
- window.open("/servlet/PharmacyController?action=SSSearchForm&WebLookup=true", "", "toolbar=no,width=700,height=500,scrollbars=yes");
- }
- function addNewPharmacy(newpharmacy, cliniccode, storename){
- if(newpharmacy!=""){
- document.all["PharmacyFrame"].src="/servlet/PharmacyController?action=AddNewSSPharmacy&SSPharmacyId="+newpharmacy+"&cliniccode="+cliniccode+"&storename="+storename+"&WebLookup=1";
- }
- }
- function setNewSSPharmacyAlert(storename){
- alert("Pharmacy already exist.");
- return false;
- }
- function setNewSSPharmacyId(pharmacyid, storename, address){
- var optn = document.createElement("OPTION");
- optn.text = storename+" "+address;
- optn.value = pharmacyid;
- AddEditForm.pharmacyId.options.add(optn);
- AddEditForm.pharmacyId.options[AddEditForm.pharmacyId.options.length-1].style.backgroundColor="#A4F4F4";
- AddEditForm.pharmacyId.selectedIndex = AddEditForm.pharmacyId.options.length-1;
- //pharmacyChanged();
- }
- //added by shreyans for c4 module
- //ended by shreyans
- </script>
- <script src="/html/calUniversal.js"></script>
- <script language="javascript">
- var selectsToHide = new Array("workStatus","studentStatus","bloodType","maritalStatus","patientDetailsAttrib");
- </script>
- <script>
- setValue("ethnicity","","SELECT","AddEditForm");
- //added by sugam on 16/8/2010
- setValue("preferredLanguage","","SELECT","AddEditForm");
- //addition by sugam ends on 16/8/2010
- //Started by chintan
- setValue("muDemographicExclusion","","SELECT","AddEditForm");
- function EnableDisableMuDemo(field){
- var muDemoOtherEle =document.getElementById('muDemographicExclusionOther');
- var muDemoEle = document.AddEditForm.muDemographicExclusion;
- var form = document.AddEditForm;
- if(field.value==""){
- muDemoEle.disabled=false;
- if(muDemoEle .value=="Other"){
- muDemoOtherEle.style.visibility = "visible";
- }
- }else if(document.AddEditForm.dateOfBirth.value!="" && document.AddEditForm.preferredLanguage.value!="" && document.AddEditForm.ethnicity.value!="" && document.AddEditForm.smoker.value!="" && document.AddEditForm.racedescription.value!=""){
- setValue("muDemographicExclusion","","SELECT","AddEditForm");
- muDemoEle .disabled=true;
- muDemoOtherEle.value="";
- muDemoOtherEle.style.visibility = "hidden";
- }
- }
- function checkReqField(muDemo){
- if(document.AddEditForm.dateOfBirth.value!="" && document.AddEditForm.preferredLanguage.value!="" && document.AddEditForm.ethnicity.value!="" && document.AddEditForm.smoker.value!="" && document.AddEditForm.racedescription.value!=""){
- setValue("muDemographicExclusion","","SELECT","AddEditForm");
- muDemo.disabled=true;
- document.getElementById('muDemographicExclusionOther').style.visibility = "hidden";
- }
- }
- function createTextBox(other){
- var obj=document.getElementById('muDemographicExclusionOther');
- if(other.value=='Other'){
- obj.style.visibility = "visible";
- }else{
- obj.style.visibility = "hidden";
- }
- }
- //Ended by chintan
- </script>
- <!-- InstanceEndEditable -->
- <br><br>
- <!--</td></tr>
- </table>-->
- <!---- footer table starts ----->
- <table width="100%" border="0" cellspacing="0" cellpadding="0" align=center>
- <tr>
- <td width=100> <a href="/vis/OmniMDTrainingManual.pdf" target="_new"><img src=/vis/help.gif border=0></a></td>
- <!--<td width=100> <a href="/html/UserManual.html#PatientAddEdit" target="_new"><img src=/vis/help.gif border=0></a></td>-->
- <td width=465>Help Desk: 914.332.5590 | <a class=menuTabSub href="/servlet/DoctorController?action=ReportProblem" class=menuTop><u>Report a Problem</u></a> | <a class=menuTabSub href="/servlet/DoctorController?action=FeedBack" class=menuTop><u>Feedback</u></a></td>
- <td width="197"><div id="thawteseal" style="text-align:center;" title="Click to Verify - This site chose Thawte SSL for secure e-commerce and confidential communications.">
- <div><script type="text/javascript" src="https://seal.thawte.com/getthawteseal?host_name=361md.omnimd.com&size=S&lang=en"></script></div></div></td>
- </tr>
- </table>
- <table cellpadding=0 cellspacing=0 border=0 width="100%" height="16">
- <tr><td width="100%" background="/vis/bgFooter.gif"><img src="/vis/trans.gif" width="1" height="16"></td>
- </tr>
- </table>
- <!---- footer table ends ----->
- <!---border table ends-->
- <table width="775" border="0" cellspacing="0" cellpadding="0" align=center>
- <tr align="right">
- <td class="copyright" align="right">Copyright © 2003 OmniMD. All Rights Reserved. OmniMD<sup>TM</sup> is a trademark of <a href="http://www.ismnet.com" class=menuTop><u>ISM, Inc.</u></a> </td>
- </tr>
- </table>
- <br><br>
- </body>
- <!-- InstanceEnd --></html>
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