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ARIZONA STATE BOARD OF NURSING Application for Registration Access to the Arizona Controlled Substances Prescription Monitoring Program CSPMP FOR OFFICE USE ONLY PRINT CLEARLY USING CAPITAL LETTERS License Type NP CNM AP Certificate Number s / Expiration Date DEA Number SECURITY QUESTIONS M Mother s Maiden Name NPI Number Your Birth City 1. DEMOGRAPHICS Legal First Name Middle Name Last 4 Digits of SSN Date of Birth 2. PRACTICE ADDRESS Street Address Line 1 City State Work Phone Zip Code - County Fax Check here if Mailing Address is the same as PRACTICE ADDRESS 3. MAILING ADDRESS 4. Practitioner s Work or Personal Email Address If a Practitioner has multiple DEA numbers you MUST complete one form for each DEA number Submit Completed form s to Arizona State Board of Nursing 4747 N* 7th Street Suite 200 Phoenix AZ 85014-3655. DEMOGRAPHICS Legal First Name Middle Name Last 4 Digits of SSN Date of Birth 2. PRACTICE ADDRESS Street Address Line 1 City State Work Phone Zip Code - County Fax C....

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Digits Related content

cspmp.pdf - Arizona State Board of Nursing
§ 36-2606. Register online at https://pharmacypmp.az.gov/ or complete the form below by...
Learn more
Controlled Substances Prescription Monitoring...
Jul 2, 2007 — Prescription Monitoring Program (CSPMP). The bill was signed ... Once your...
Learn more
cspmp.pdf - Arizona State Board of Nursing
§ 36-2606. Register online at https://pharmacypmp.az.gov/ or complete the form below by...
Learn more

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Substances Questions & Answers

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What information does the PMP provide? Schedules II-V controlled substance prescription information. Records viewable for 12 months and kept on record for two years.

What requirements are there to become a DEA agent? DEA agents must be 21-36 years old; possess U.S. citizenship; and have excellent vision, hearing, and physical fitness. DEA candidates also need a criminal justice-related bachelor's degree or professional experience.

Apply online at the U.S. Department of Justice website. ... Call the DEA Headquarters Registration Unit toll free at 800-882-9539 or call your nearest DEA Registration Field Office to request a physical copy of the order form.

The Texas Prescription Monitoring Program (PMP) collects and monitors prescription data for all Schedule II, III, IV, and V Controlled Substances (CS) dispensed by a pharmacy in Texas or to a Texas resident from a pharmacy located in another state.

The DEA Registration is required of all who import/export, manufacture, distribute, prescribe, dispense or administer any Controlled Dangerous Substances. ... The CDS license is simply the manifestation of the state's authority to work with controlled substances.

Registration Fees For practitioners, the fee for DEA registration has increased from $731 to $888. The new fee schedule has been implemented for all initial applications submitted on or after October 1, and for all renewal applications submitted on or after October 1.

When pharmacists dispense controlled substances to patients, they have to enter the prescription into the state PDMP. However, pharmacies submit this data to state PDMPs at varying intervals ranging from monthly to daily or even in real-time, i.e., under five minutes.

CONTROLLED SUBSTANCES PRESCRIPTION MONITORING PROGRAM. (CSPMP)

A: The Prescription Monitoring Program Registry provides practitioners and pharmacists with direct, secure access to view their patients' recent controlled substance prescription history to help them better evaluate a patient's treatment as it pertains to controlled substance prescribing and dispensing.

Apply online at the U.S. Department of Justice website. This resource is only available to new applicants. Call the DEA Headquarters Registration Unit toll free at 800-882-9539 or call your nearest DEA Registration Field Office to request a physical copy of the order form. Forms will be mailed within 10 working days.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232