Pharmacy Refill Requests

Medical Services : Community Pharmacy : Pharmacy Refill Requests

Pharmacy Refill Requests at St. Alexius Community Pharmacy

Thank you for choosing the St. Alexius Community Pharmacy. If you have any questions with this online process or your medications, feel free to call us at (701) 530-6906.

Refilling your prescription is a simple process. Just complete the information below and we will refill your prescription as quickly as possible.

 Check this box if your personal information has changed since your last prescription refill.

 Check this box if generic drugs are acceptable.

* Required Fields

* First Name
* Last Name
* Address
Address 2
* City
* State
* Zip Code
* Phone Number
* Email Address
Refill Number Medication Name
Community Pharmacy, 900 East Broadway
(located best at the East Patient Entrance on the corner of Rosser and 10th Street)
Select Delivery Method

 At the Pharmacy

 Mail the prescription

Select a Payment Method

 Pay at the Pharmacy

 Pay with a Credit Card

* Expiration Date

/

* Card Number

 

 

 

V Code is the 3 or 4 digit number on the back of your credit card. The V code is located in the signature line or is the last 3 or 4 numbers directly after your credit card number.

Scroll to Top