Enrollment - Print Card
(fold on dotted line)
Show your card: Give this card to the pharmacist each time you
place your prescription order.
THIS IS NOT INSURANCE - DISCOUNTS ONLY
By using this card the holder agrees to the terms under which it was issued. Void where prohibited. Process all prescriptions electronically.
Customer Service: 1-440-266-0800
Pharmacy Help Desk: 1-800-847-7147
THIS IS NOT INSURANCE - DISCOUNTS ONLY
By using this card the holder agrees to the terms under which it was issued. Void where prohibited. Process all prescriptions electronically.
Customer Service: 1-440-266-0800
Pharmacy Help Desk: 1-800-847-7147
| Name: _______________________ | |
| MEMBER ID: | NHA151807 |
| GROUP ID: | NHA15 |
* This card is valid for all
family members *
powered by
Agelity
TM
BIN: 009265
PCN: AG
PCN: AG
We suggest inserting a more durable paper into your printer for the best quality and usage length of your card. Also, you may want to consider having the card laminated. Thank you again for enrolling with us!