Get the free Fax completed form to (866-759-4115) or mail to Nebraska Total Care, Inc

Fax completed form to (8667594115) or mail to Nebraska Total Care, Inc. MAP Dept. Attention: NE Senior Pharmacist, 2525 N. 117th Ave, Ste 100 Omaha, NE 68164 Nebraska Department of Health and Human

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8. Once the form is completely filled out and reviewed, send it through fax. Ensure the fax number is correctly entered and that all pages are transmitted clearly. Retain the fax confirmation receipt for future reference.

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