Use this form for exact reorders only of medical supplies previously received from Hartzell's Pharmacy.
For new orders, contact our care specialists directly at 484-240-6440.
Your order will take 3 to 5 business days to complete, provided all required documentation is on file and current.
Fill out this section with your contact information
In this section, think of "Prescriptions" as Medical Supplies.
Simply fill out the information accordingly:
[Rx Number]: Number of Medical Supply Items to Order
[Medication Name]: Name of Medical Supply Item
Let us know of any additional details or requests, and a friendly member of our staff will be in touch very shortly thereafter!