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Mass. gov/dph/dcp For MA Online PMP information visit http //www. mass. gov/dph/dcp/onlinepmp In the boxes below enter the requested information. 1 Degree Select one MD DMD DDS DO DPM RN/NP RN/NM RN/PC RN/NA RPh CDTM only PA 4 DEA Controlled Substance Registration No. If possessed 5 List additonal DEA numbers and DEA X numbers used on prescriptions that might be dispensed in MA pharmacies. 6 Name First Middle Last Suffix e.g. Jr. Sr. II III 7 Bus...
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Prescribers online mass form is a document that is used to report the prescribing activities of healthcare professionals online in a bulk format.
Healthcare professionals who prescribe medications online in bulk are required to file prescribers online mass form.
To fill out prescribers online mass form, healthcare professionals need to provide information about the medications prescribed, the patients, and the online platform used for prescribing.
The purpose of prescribers online mass form is to keep track of the prescribing activities of healthcare professionals online and ensure compliance with regulations.
On prescribers online mass form, healthcare professionals must report information such as the name and dosage of prescribed medications, the number of patients, and the online platform used for prescribing.
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Related Links

Your Mail Service Pharmacy Benefit
Remember to mail your prescription with this completed form. Your medication will arrive within two weeks from the date we receive your first order. NOTE: ...
MA Controlled Substances Registration (MCSR) Research ...
In addition to completing the application form online, an application fee of $150 payable by credit or debit card or an electronic check will need to be entered ...
Diversion Control Division | DEA Forms & Applications
Registration Applications &Tools · Renewal Applications. Form 224a, Form 225a, Form 363a, Form 510a · New Applications · Check the Status of My Application.

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