Get the free FAX OR MAIL this form to: State of Louisiana Form:...

FAX OR MAIL this form to: La Medicaid Rx PA Operations ULM School of Pharmacy 1800 Belville Drive Monroe, LA 71201-3765 FAX 866-RX PA FAX 866-797-2329 State of Louisiana Form: Rx PA16 Department of

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What is fax or mail this?

Fax or mail this is a method of submitting documents or information by sending them through fax or mail.

Who is required to file fax or mail this?

Anyone who needs to submit documents or information in a physical format may be required to file fax or mail this.

How to fill out fax or mail this?

To fill out fax or mail this, simply follow the instructions provided for submitting the documents or information through fax or mail.

What is the purpose of fax or mail this?

The purpose of fax or mail this is to provide an alternative method for submitting documents or information when electronic submission is not possible.

What information must be reported on fax or mail this?

The specific information that must be reported on fax or mail this will depend on the requirements of the documents or information being submitted.