Max Lagin - Submit Order Inquiry

Name *

Email Address *

Subject *

Phone *

Company *

Are you NDC Specific?

Medication or NDC #1 Approximate quantity:

Units or Cases?

Medication or NDC #2 Minimum number of cases:

Units or Cases?

Medication or NDC #3 Minimum number of cases:

Units or Cases?

How soon or when approximately do you need this order by?*

Message (include any additional details)

Email:

E-mail Max

Phone:

Max +1 480 664-4472

Location:

Phoenix, AZ

Response Time:

I will contact you regarding your order inquiry as soon as possible, typically within one business day.