User Information:
*Required fields
*First Name:
*Last Name:
*E-mail:
*Please reenter e-mail address:
*Daytime Phone Number: (Example 8475551234)
Extension:
*Sales Rep Name:
 

Please complete the appropriate Product Line section(s):
Medical Products and Services website
   Base Business or Valuelink(Just in Time Ordering)
    Account Number: 8 digit SoldTo only (1xxxxxxx)
  Internal Use Only:
Medical eCommerce website
   Ambulatory
    Account Number: 8 digit SoldTo or ShipTo (1xxxxxxx, 2xxxxxxx)
  Internal Use Only:
  Pharma Account Number:
Pharmaceutical Distribution (formerly Cardinal Distribution)
  Distribution Center:
    Account Number: (6 digits)
    Account Name:
Specialty Pharmaceutical Distribution
    Account Number: (6 digits)
  Account Name:
Due to our detailed and thorough registration process, it will take 24 to 48 hours for you to receive your new user login ID. This user ID will enable you to enter our site and explore all the products and services we have to offer in a way that is customized to your needs.