 |
Pharmacies - Enroll Your Pharmacy |
What to Expect |
As part of Organization Registration, you will be asked for the following information: |
|
ImmTrac2 Participating Organizations |
If your organization participates with the Texas Immunization Registry (ImmTrac2), you will need the ImmTrac2 Organization Code. |
|
TVFC Provider Organizations |
If your organization previously enrolled with the Texas Vaccines for Children and Adult Safety Net Program, you will need your TVFC/ASN PIN. |
|
Information Need to Complete Registration |
All organizations will need to provide the following information to complete the registration process.
- Organization Name
- Organization's Physical and Mailing Addresses
- Organization's Phone Number (main phone number)
- Organization's Fax Number
- Your Contact information: First Name, Last Name, Phone Number and a unique email address
- Organization Point of Contact: First Name, Last Name, Phone Number and a unique email address
- Primary Registry Point of Contact: First Name, Last Name, Phone Number and a unique email address
- Responsible Medical Professional: First Name, Last Name, Phone Number and a unique email address, Texas Medical License, License Type, Individual National Provider Identification Number (NPI), Specialty, Medicaid ID.
|
|
|