Thank you for your interest in participating in the 4D Pharmacy Provider Network.  As a pharmacy benefits manager, 4D realizes the invaluable role pharmacy providers play in prescription delivery and in keeping the individuals in our country healthy.  It is your service, knowledge and education that enables individuals to receive and properly administer the medications they need.

Please provide the following information.  Note that submitting this information does not gain your pharmacy access into the Network.  Our Provider Network Team will furnish you with the necessary documents to formally request admission to the Network.