Beyond the script, ahead of the curve.

Complete to begin your

partnership with

Southend Pharmacy

Southend Pharmacy is a 503A compound pharmacy dedicated to dispensing customized medications for individual patient need at the direction of the medical provider. Partner with Southend Pharmacy:

A 503A Compounding Pharmacy
LegitScript Certified
Offers convenient and reliable shipping to 25+ states
3rd party testing on all medications
Dedicated account managers for account support

Don't worry – our turnaround times are under 72 hours and we can still ship to clinics for patient use!

Southend Pharmacy does not provide office-use compounded products as we are designed by the FDA as a 503a pharmacy, which require patient-specific prescriptions before dispensing compounds.

Healthcare Provider Onboarding

***Please note that the individual filling out and signing this form must hold a valid medical license in each state in which you provide medical services, possesses the legal right to enter into a binding agreement, and accepts without limitation conducting this transaction electronically, disclaimers of warranties, damage and remedy exclusions and limitations, arbitration and choice of Texas law. Such individual represents and warrants that he or she has the authority to enter into and bind the Provider to the Agreement terms.

Tell us about yourself

Medical Provider Information

Expiration Date

Provider NPI

Provider type

Medical Provider Information

Supervising Physician's NPI Number

Supervising Physician’s First Name

Supervising Physician’s Last Name

Terms and Conditions, Credit Card Authorization & Recurring Payments

Here’s How Recurring Payments Work:

You authorize Southend to charge to your credit card when you submit an order for a prescription product with us. You will be charged the Product Price plus all pass through shipping.

Recurring Credit Card Authorization

You may choose to have your prescription product orders automatically charged to your Visa, MasterCard, American Express, or Discover Card upon your submission of a prescription order to AP Max, Inc. d/b/a Southend Pharmacy (“Southend”) in your LifeFile account.

You will have the opportunity to add your Credit Card information in LifeFile when you send your first prescription, after that we will have it saved in your billing profile.

I understand that AP Max Incorporated, d/b/a Southend Pharmacy, requires payment via credit card prior to shipment of all Product orders. I understand that I will have the option to make payment or require my patients to make payment upon my submission of Product orders.

I attest that I have read and agree to Terms and Conditions.

By providing your mobile number, you agree to receive SMS messages from Southend Pharmacy regarding your account and pharmacy services. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out or HELP for assistance. Consent is not a condition of purchase.

Clear

With my signature below , I agree to the terms and conditions and pricing, and if applicable, credit card authorization