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Instructions:
Please use the database’s Search Covered Entities function to verify your entity’s Authorizing Official before submitting an online change or termination request. If the Authorizing Official listed in the database for your entity is no longer correct, but that individual is still available to certify the request (via email), you may continue with the electronic change and/or termination request process.
 
If the existing Authorizing Official is NOT available, you must cancel this request and submit a manual change request form with the new official’s name and contact information. Once that request has been approved by OPA, you may proceed online with the change and/or termination request.
 
You will receive an automated confirmation e-mail after submitting your request; the Authoring Official on record for your covered entity will receive a separate e-mail with further instructions for accepting or rejecting the proposed changes or accepting or rejecting the termination request.


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OMB Number: 0915-0327, Expiration: 10/31/2015
U.S. Department of Health and Human Services (HHS)
Health Resources and Services Administration (HRSA)
Office of Pharmacy Affairs (OPA) - 340B Program
April 23, 2014
7:47 AM ET
Questions, Comments, or Suggestions
Email Us: ApexusAnswers@340bpvp.com
Call Us: 1 - 888 - 340 - 2787

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