Class 1
Class 1
Items may only be sold to Medical Physicians Licensed and Practicing
in the State of New York
Examples of Items:
To Purchase you will need to Mail:
- A completed Class
1 Authorization Form signed (Original Signature, no copies)
by the purchasing Physician.
- A copy of the purchasing Physician's State Medical License
- A copy of the purchasing physician's DEA Federal Controlled Substance
License
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Class 2
Class 2
Items may only be sold to Medical Physicians and have no
state restrictions.
Examples of Items
-
Diagnostic Tests requiring
blood sample
-
Some Equipment (Pulse Oximeter,
Automatic External Defibrillators)
To Purchase you will need to Mail:
- A completed Class
2 Authorization Form signed (Original Signature, no copies)
by the purchasing Physician.
- A copy of the purchasing Physician's State Medical License
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Medical Businesses (Medical Practice, Home Care, Nursing
Home, etc.)
must utilize Overseeing Physician when completing forms
Class
1 Authorization Form
Class 2 Authorization Form
Please mail forms to:
MohawkMedicalMall
Attn: Restricted Account Setup
PO Box 27
Utica, NY 13502
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Questions? Please Contact Us:
Phone: 1.800.962.5660
eMail:
Customer Service
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