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MDHHS5942V, WIC FULLING VENDOR APPLICATION Michigan Department of Health and Human Services (Revised 122)SECTION 1 WOMEN, INFANTS, AND CHILDREN (WIC) OFFICE USE ONLY North___Central___SE___OAP___Unfilled

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How to fill out wic pharmacy vendor application

01

Obtain a copy of the WIC pharmacy vendor application form from the local WIC agency or website.

02

Fill out all required sections of the application form accurately and completely.

03

Provide any requested documentation or supporting materials, such as proof of licensure and accreditation.

04

Submit the completed application form and any required materials to the appropriate WIC agency for review and approval.

05

Attend any necessary orientation or training sessions as required by the WIC program.

Who needs wic pharmacy vendor application?

01

Pharmacies that wish to participate in the WIC program and provide services to WIC participants.

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What is wic pharmacy vendor application?

The WIC pharmacy vendor application is a form that pharmacies must complete in order to participate in the WIC program and provide services to WIC participants.

Who is required to file wic pharmacy vendor application?

Pharmacies looking to become authorized WIC vendors are required to file the WIC pharmacy vendor application.

How to fill out wic pharmacy vendor application?

To fill out the WIC pharmacy vendor application, pharmacies need to provide information about their location, services offered, pricing, and compliance with WIC program requirements.

What is the purpose of wic pharmacy vendor application?

The purpose of the WIC pharmacy vendor application is to ensure that pharmacies meet the necessary criteria to participate in the WIC program and provide quality services to WIC participants.

What information must be reported on wic pharmacy vendor application?

The WIC pharmacy vendor application requires pharmacies to report information about their location, services offered, pricing, and compliance with WIC program requirements.

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