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CANNON BUILDING 861 SILVER LAKE BLVD. SUITE 203 DOVER DELAWARE 19904-2467 TELEPHONE 302 744-4500 FAX 302 739-2711 WEBSITE DPR*DELAWARE*GOV STATE OF DELAWARE OFFICE OF CONTROLLED SUBSTANCES EMAIL customerservice. Dpr state. de. us APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION PRACTITIONERS Other than Physician s Assistants and Advanced Practice Nurses INSTRUCTION SHEET General Information You must hold a Delaware practitioner license e*g* Physician Dentist etc* before your application...

How to fill out application for controlled substances

How to fill out APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION – PRACTITIONERS

1. Obtain the APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION form from your local regulatory authority or their website.
2. Carefully read the instructions accompanying the application form to understand the requirements.
3. Fill out your personal information, including your name, address, and contact details.
4. Provide your professional details, including your medical license number, type of practice, and specialty.
5. Indicate the specific controlled substances you intend to prescribe or handle.
6. Include information on any previous registrations and any disciplinary actions if applicable.
7. Ensure to attach any required documentation, such as proof of identity, medical license, or certification.
8. Review the application for completeness and accuracy before submission.
9. Submit the completed application form to the appropriate regulatory authority, along with any applicable fees.
10. Await confirmation and any additional requirements from the regulatory agency.

Who needs APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION – PRACTITIONERS?

1. Any healthcare practitioner, such as a physician, dentist, or nurse practitioner, who intends to prescribe or handle controlled substances in their practice.

People Also Ask about

How to get 222 forms?

DEA 222 forms are available to active registrants at no charge. DEA 222 forms may be ordered by calling: DEA Headquarters Registration Unit toll free at 800-882-9539.

How much is a DEA license for NP?

The cost of a DEA license depends on several factors, including the type of practitioner applying for the registration. The initial application can range from $731 to $3,007, with higher fees for those in certain specialized categories.

How much does a DEA license cost?

How Much Does a DEA License Cost? The cost of a DEA license depends on several factors, including the type of practitioner applying for the registration. The initial application can range from $731 to $3,007, with higher fees for those in certain specialized categories.

How to apply for DEA license NP?

I am a nurse practitioner (NP): How do I apply for DEA number? 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.

What is the difference between NPI and DEA license?

The NPI Number, specifically used for Medicare & Medicaid billing, can also be used to identify and track a much broader set of transactions a provider may perform, while the DEA Number is a requirement specifically for prescribing and administering controlled substances.

How to apply for a CDS license?

How to obtain a CDS license? Step 1: Determine the requirements in their state. Step 2: Complete the necessary education and training. Step 3: Obtain the necessary documentation. Step 4: Apply for the license. Step 5: Maintain compliance with state and federal laws.

How does an NP get a DEA number?

I am a nurse practitioner (NP): How do I apply for DEA number? As an NP who administers, prescribes or dispenses any controlled substance, you must be registered with the federal Drug Enforcement Administration (DEA). To obtain the official order form, you may: Apply online at the U.S. Department of Justice website.

What do you need for DEA registration for individual practitioners?

If you are applying for an Individual Registration (Practitioner, MLP, Researcher) you are required to provide your Full Name, Address, Social Security Number, and Phone Number. If you are applying for a Business Registration, you are required to provide the Name of the Business, Address, Tax ID, and Phone Number.

For pdfFiller’s FAQs

What is APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION – PRACTITIONERS?

The APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION – PRACTITIONERS is a form that healthcare providers must fill out to obtain permission to lawfully prescribe, administer, or dispense controlled substances.

Who is required to file APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION – PRACTITIONERS?

Practitioners such as physicians, dentists, veterinarians, and other licensed healthcare providers who intend to handle controlled substances for medical purposes are required to file the application.

How to fill out APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION – PRACTITIONERS?

To fill out the application, practitioners must provide personal information, professional qualifications, and details about their practice, and may also need to submit supporting documents as required by the regulatory authority.

What is the purpose of APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION – PRACTITIONERS?

The purpose of the application is to ensure that practitioners are qualified and authorized to handle controlled substances safely and responsibly, thereby preventing misuse and ensuring compliance with legal standards.

What information must be reported on APPLICATION FOR CONTROLLED SUBSTANCES REGISTRATION – PRACTITIONERS?

The information reported must include the practitioner's personal identification details, professional credentials, the type of controlled substances they intend to handle, practice location, and any prior disciplinary actions or criminal history.