Refill a Prescription

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Last name on prescription

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Prescription #

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Store #
Enter the store number as it appears on the
label of your prescription bottle as
highlighted below.

5454 PHARMACY BLVD
BOCA RATON, FL 36363
STORE # 0018
561-444-6666 07/11/11
RPh: PRX
RX # 6226626
MILLER, D
DOE, JOHN M
TAKE 1 TABLET BY MOUTH
ONCE A DAY.

ASPIRIN 325 MG TABLET
GEN FOR: ECOTRIN 325 MG
TAB
90TAB
4 REFILLS BEFORE 07/11/12
ORG DT - 05/04/11
DISCARD AFTER: 07/11/12

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