Have your diabetes monitoring & testing supplies delivered to your door & have more time for the things you love to do!
Call or Apply Online
(Be sure to click SUBMIT button after completion)
Home Phone, if different:
Social Security Number:
or Other Insurance #:
Name of Insurance Co.:
CALL US TOLL FREE AT 1-800-408-0240
now to speak to aPatient Care Specialist or
fill out the form below to have our Specialist
contact you to verify your insurance benefits
and answer questions you may have
about our program.
Local - 336-661-1669 — Fax - 336-661-1678
Free Delivery right to your home.
We fill out all the insurance paperwork for you.
No claim forms to fill out - We do it for you.
No waiting for reimbursement.
Medicare, Medicaid and private insurances welcome.