NebuPent Patient Assistance Program
Valeant Pharmaceutic
Contact Information
NebuPent Patient Assistance Program
1101 Perimeter Drive
Suite 300
Schaumberg, IL 60173
1-(847) 330-1289 (phone)
NebuPent Patient Assistance Program
1101 Perimeter Drive
Suite 300
Schaumberg, IL 60173
1-(847) 330-1289 (phone)
Eligibility:
The doctor needs to include financial and insurance information about the patient in a letter which includes the name and dose of the drug, the doctors state license number and DEA, a complete shipping address, and the name of whoever will administer the product. The physician must sign the letter. The doctor will recieve and must sign a contract affirming that the product will not be resold or diverted to another patient.
The doctor needs to include financial and insurance information about the patient in a letter which includes the name and dose of the drug, the doctors state license number and DEA, a complete shipping address, and the name of whoever will administer the product. The physician must sign the letter. The doctor will recieve and must sign a contract affirming that the product will not be resold or diverted to another patient.
Other Information:
Another letter is required for re-enrollment
Another letter is required for re-enrollment
