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Open an Account
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New Customers:

Non-Hospital

  1. Fill out all parts of the application

  2. Provide a photocopy of a provider's active state medical license

  3. Complete one payment section:

    • ​Invoice billing (credit app)​​

    • Credit card payment (credit card app)​​​

   

Please fill out either the paper application or the online application. For the online application, please fill out all required parts.

Hospital

  1. ​Fill out all parts of the application 

  2. Complete the credit application for invoice billing

  3. Check the applicable and sign the Terms & Conditions page. 

If you are an office located within a hospital, please provide a photocopy of a providers license to have on file. 

Please allow 24-48 hours for your account to be reviewed and processed. Once that has been completed, you will receive an email from our customer service manager letting you know that your account has been set up and you can place orders. You may submit orders via email to customerservice@hpsrx.com, phone at 800-850-1657, or fax to 800-361-6984

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