Potaba Patient Assistance Program
Glenwood, LLC
Contact Information
19 Empire Blvd
PO Box 1508
So Hackensack, NJ 07606
1-(800) 542-0772 (phone)
1-(201) 221-0060 (fax)
19 Empire Blvd
PO Box 1508
So Hackensack, NJ 07606
1-(800) 542-0772 (phone)
1-(201) 221-0060 (fax)
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
- Click here to visit the program's web site.
- Potaba
Eligibility:
Income guidelines apply.
Income guidelines apply.
Other Information:
This program is limited to a maximum of 25 patients at any one time.
This program is limited to a maximum of 25 patients at any one time.
Product(s) covered by program:
