Last updated: 1/26/2024
Application For Initial Registration Or Transfer Of Ownership Of Pharmacy {PH 200}
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Description
PH 200 - APPLICATION FOR INITIAL REGISTRATION OR TRANSFER OF OWNERSHIP OF PHARMACY. This form is used in the State of New York for individuals or entities seeking to register or transfer ownership of a pharmacy. The form requires details such as the name under which registration is sought, address, type of ownership, contact information, and information about the supervising pharmacist. It includes questions related to the moral character of the applicant, their criminal history, and any past professional misconduct. The form also requires information about pharmacists, interns, and ownership interests in other registered entities. Additionally, it includes an attestation of the registrant and supervising pharmacist, along with details of corporate officers, partners, and stockholders. The completed form, along with the required fee, is submitted to the New York State Education Department for processing. www.FormsWorkflow.com
