Get Cppa Specialty Pharmacy Practice Accreditation Application 2014-2025

The CPPA Specialty Pharmacy Practice Accreditation Application is a crucial document for pharmacies seeking accreditation. This guide provides a step-by-step approach to completing the application online, ensuring all necessary information is accurately submitted.

Follow the steps to successfully complete your application

1. Press the ‘Get Form’ button to access the application and open it in the editor.
2. Begin by entering the pharmacy's corporate name and any 'Doing Business As' names, if different.
3. Provide the pharmacy's URL(s) along with the complete business address, including street address, city, state, and zip code.
4. Fill in the telephone number and fax number for the pharmacy, ensuring accurate entries to facilitate communication.
5. Enter the email address of the pharmacy or pharmacist-in-charge, alongside the pharmacy license number and its expiration date.
6. Include the Drug Enforcement Administration (DEA) registration number along with its expiration date.
7. If applicable, list the state controlled substance license and its expiration date.
8. Add the federal employee identification number (EIN) and national provider identification (NPI) number.
9. If relevant, provide the Medicare billing number and the National Council for Prescription Drug Programs (NCPDP) number.
10. Include Medicaid provider numbers if applicable.
11. Moving to the pharmacist in charge (PIC) section, fill in their full name and CPE monitor number if applicable.
12. List the degrees earned by the PIC, starting with the highest degree listed first, followed by their credentials and certificates.
13. For the supplemental documents section, prepare required documentation such as the organizational chart of pharmacy personnel.
14. Compile additional licenses for pharmacists and technicians, including state information and expiration dates.
15. Disclose any relationships between owners, outlining any other ownership interests with detailed descriptions.
16. Finally, review all entries before saving changes, downloading, printing, or sharing the application.

Start completing your CPPA Specialty Pharmacy Practice Accreditation Application online today!