Orders

We offer a wide range of healthcare services to our patients and member pharmacies. We are dedicated to providing personalized care and excellent customer service to help our patients live healthier, happier lives.​

Encapsulation

Ideal for converting powdered medications into capsule form.

ORDER FORM - Encapsulation

ORDER FORM - Encapsulation

Order Information

Order Type

Maximum file size: 256MB

Please attach a picture or scan of the prescription(s).If you would rather fax the prescription, please add E1000 to your fax for authentication purposes.

Pharmacy Information

Pharmacy Address
Pharmacy Address
Street Address
Street Address 2 (Optional)
City
State/Province
Zip/Postal
Country

Prescription and Patient Information

Encapsulation Product

Insurance

Insurance

Shipping

Shipping

Total Cost

Authorization Information

Billing Information

First Name
Last Name
Billing Address
Billing Address
Street Address
Street Address 2 (Optional)
City
State/Province
Zip/Postal
Country

Shipping Information

First Name
Last Name
Shipping Address
Shipping Address
Street Address
Street Address 2 (Optional)
City
State/Province
Zip/Postal
Country

Preparation Location

Pharmacie N. Bestawros, C. Shefteshy et K. Manoukian (Gouin)
5595, boul. Gouin, Montréal, (Québec), H4J 1E5
Pharmacie N. Bestawros, C. Shefteshy et K. Manoukian (St-Jérôme)
100-305, rue du Docteur-Charles-Leonard, Saint-Jérôme, (Québec), J7Y 0M9
Pharmacie N. Bestawros, C. Shefteshy et K. Manoukian (Hochelaga)
9080, rue Hochelaga, Montréal, (Québec), H1L 2N9

Start Over

ProductUnit of ProductionCost per 1 UnitAmount of ProductCost of Product
Acide Folique 1mg11.3501013.500
Acide Folique 5mg11.3501013.500
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