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Prescription List

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Send us Your RX List, Dosage, and Preferred Pharmacy and We Will Contact You about Your RX Plan!

Prescription List Form

"*" indicates required fields

Client Name

First Name Last Name

Phone

RX 1-4

(ex: levothyroxine 40mcg, atorvastatin 50 mg, metoprolol succinate 50 mg, Xarelto 20 mg

RX 5-10

Preferred Pharmacy:

Additional RX:

This field is for validation purposes and should be left unchanged.

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30386 Mt. Vernon Road
Princess Anne, MD 21853

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410-651-2110 local
888-651-2111 toll-free
410-651-9288 fax

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We are licensed in DE, FL, MD, and VA.
We are licensed in AR, DC, NC, and PA for life and health only.

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At Landmark Insurance & Financial Group, Inc., our mission is to help you. Protection, education, and integrity are the foundation of what we do. Utilizing the power of an independent agency, we strive to uphold our motto: “Large Enough to Serve You, Small Enough to Care!™”

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