OmniSYS, LLC.

Support: 800.666.4797
Sales: 800.448.6891
Local: 903.455.0461
Fax: 903.455.7910
E-mail: mail@omnisys-llc.com

signup to enroll in CareCLAIM

Signing up for CareCLAIM is a simple 3 step process:

1) COMPLETE and submit the enrollment information below
2) After you receive your enrollment packet in the mail (usually within 3-5 business days), SIGN the forms where indicated
3) MAIL the completed and signed forms to:

OmniSYS, LLC.
PO Box 8489
Greenville, TX 75404-8489

Legal Store Name

D.B.A.

Address

City-State-Zip


Telephone

Fax

E-Mail Address

NABP #

Medicare Provider #

Participating/Non-Participating

Software Vendor

Tax I.D. Number

Buyers Group (if applicable)

Pharmacist in Charge



Home SupportContact UsSitemapPrint Email Webmaster