Medical Billing Form Super Pharmacy & Medical Equipment Washington, DC (202) 388-0050

Navigation

Medical Billing Form

Home » Medical Billing Form

Please complete this form and press "Submit" button below, so we can evaluate your request.

Patient's Information First Name * Last Name * Address * Address 2 City * State/Province * Zip/Postal Code * Gender D.O.B. Phone * E-mail * Height Weight Medical Name/Insurance * Primary Insurance Secondary Insurance Other I'd like more information on these products

Doctor's Information Doctor's Name * Address * Address 2 City * State/Province * Zip/Postal Code * Phone Fax Do you have a prescription? Diagnosis

Hours

Pharmacy Hours

Mon	10:00 am	6:00 pm
Tue	10:00 am	6:00 pm
Wed	10:00 am	6:00 pm
Thu	10:00 am	6:00 pm
Fri	10:00 am	6:00 pm
Sat	Noon	4:00 pm
Sun	Closed

Store Hours

Mon	9:00 am	7:00 pm
Tue	9:00 am	7:00 pm
Wed	9:00 am	7:00 pm
Thu	9:00 am	7:00 pm
Fri	9:00 am	7:00 pm
Sat	10:00 am	4:00 pm
Sun	Closed

Announcements

Mobility Rentals
Day, week, or month!

Super Pharmacy & Medical Equipment

Address

1019 H ST NE
Washington, DC 20002

Contact

Phone: (202) 388-0050
Fax: (202) 388-6470

About Us

Super Pharmacy & Medical Equipment Washington, D.C. 8667872791. We specialize in prescriptions, DME and home health care products serving the entire Washington, DC area. We sell quality products from Invacare, Golden Tech and Drive Medical.

Home Page
Super Pharmacy & Medical Equipment

This Page
Medical Billing Form