To quickly and securely send prescriptions to our pharmacy: Type directly onto our online prescription form. Click the SUBMIT button to send to our pharmacy. Precision Compounding Pharmacy Bellmore, NY 11710 Phone: (516)833-6262 Fax: (516)222-0605 Email:[email protected] Patient Name: DOB: Address: Cell: Allergies: Today's Date: Rx **This prescription is not eligible for controlled substance medications** Prescriber Notes: Prescriber: Phone: Address: Email: NPI: DEA: Number of Refills: Digital Signature: By submitting this form, you confirm that you are the person noted in the digital signature and are authorized to write this prescription. Please help us eliminate spam by answering this question correctly: Which is larger, 7 or 9? Δ Contact Us for Online Prescription Assistance CONTACT US