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By completing this short registration you will be on your way to substantial medication purchase savings.

Did you know when making purchases through Sofyia, you get the best prices from our wholesale partners with a single, low minimum cart order?
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Did you know when making purchases through Sofyia, you get the best prices from our wholesale partners with a single, low minimum cart order?

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Did you know when making purchases through Sofyia, you get the best prices from our wholesale partners with a single, low minimum cart order?

Authorized Registrant

First name must be at least 3 characters

Last name must be at least 2 characters

Title must be at least 2 characters

Enter a valid email

Password

Password must be 6-12 characters

Passwords do not match or password format is not accepted

Guest accounts are limited to 3 logins total and will be required to fill out banking information prior to activating the account.

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You're just steps away from joining the fastest-growing network of pharmacists who enjoy amazing savings on their medication purchases every day!

Pharmacy Information

Enter a pharmacy name

Enter a DBA name

Enter a 7 digit NCPDP number

Enter a 10 digit NPI number

FID must be 9 to 12 digits

Enter a pharmacy phone

Enter a pharmacy fax

Enter a valid pharmacy email

Enter an initial order amount

Enter years in business

Pharmacy Address

Enter a pharmacy address

Enter a pharmacy city

Pharmacy state is requried

Enter a pharmacy zip

Shipping Address

Enter a shipping address

Enter a shipping city

Shipping state is required

Enter a shipping zip

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We have partnered with the top VAWD (ADD) accredited wholesale partners to bring you the highest-quality products at the lowest price.

Pharmacy Billing Address

Enter a shipping address

Enter a billing city

Billing state is required

Enter a billing zip

Accounts Payable Contact

Name must be at least 3 characters

Enter a contact phone

Enter a contact fax

Enter a contact email

Purchasing Contact

Name must be at least 3 characters

Enter a contact phone

Enter a contact fax

Enter a contact email

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Sofyia has a complete supply of CBD coming soon.

Licenses

Must enter a 9 digit DEA number

Must enter DEA expiration date

Must enter State License number

Must enter State License expiration date

Upload DEA License
Uploaded File {{deaUploaded}}
Upload State License
Uploaded File {{stateUploaded}}

Enter state license name

*

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Sofyia has a complete supply of CBD coming soon.

Controlling Entity

Select ownership type

Enter owner

Enter %

Enter last 4

Enter controlling entity name

Enter applicant relation to entity

Enter phone

Enter entity address

Enter entity city

Entity state is required

Enter entity zip

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Sofyia has a complete supply of CBD coming soon.

Primary Supply Provider

Enter name

Enter account number

Enter contact name

Enter contact phone

Primary Technology Provider

Enter name

Enter account number

Enter contact name

Enter phone

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Sofyia has a complete supply of CBD coming soon.

Banking Information

Please finish filling out your bank information to complete registration.

Routing number is not valid

Account number is not valid

Bank name must be valid

Enter entity address

Enter entity city

Entity state is required

Enter entity zip

Name is required

Phone is required

Signature

Create signature by using your finger or mouse in the gray box below:
This signature will be used as Purchase Order Authorization and appears on purchase orders.
Clear Signature
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Sofyia has a complete supply of CBD coming soon.

Bank Authorized Contact

Name is required

Email is required

Phone is required

Fax is required

Alternate contact is required

Guarantor

Enter guarantor address

Enter entity city

Entity state is required

Enter entity zip

Enter last 4 of social

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Sofyia has a complete supply of CBD coming soon.

Your Final Step is the Signature on the Contract

By clicking this box, you agree to the ACH Debit agreement and Security agreement. By clicking this box, you agree to the Security agreement.
Bank verification failed. Please review your information or contact your bank to proceed with registration or try another account.
By clicking this box, you agree to receive emails.
Click here to finish guest registration
Click here to access and sign contract
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