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Get Ohsu Mail Order Pharmacy

U Mail Order Pharmacy 9315 SW Nimbus Ave Beaverton, OR 97008 Fax to OHSU Mail Order Pharmacy: 503-346-3371 mailorder ohsu.edu OR Today s Date: PATIENT NAME & ADDRESS Last Name: Middle: First: Apt: Street Address: City: State: Aspirin M F E-mail Address: Phone #: ( ) - Member ID: Rx Bin: None Sex: No Changes (check if no changes since last order) Prescription Plan Name: Drug Allergies: P.O Box: Zip Code: PATIENT PROFILE Rx Group: Birth Date: Codeine Rx PCN: Penicillin.

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