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AbbVie Inc. – VyALEV Complete enrollment program fax number

(888) 953-2762

Enrollment and Prescription (Specialty Pharmacy)

Used for: Prescriber enrollment and prescription submission for the VyALEV Complete program

Fax destination details

Department
Enrollment and Prescription (Specialty Pharmacy)
Purpose
Prescriber enrollment and prescription submission for the VyALEV Complete program
Form
Enrollment and Prescription Form — VYALEV COMPLETE Enrollment and Prescription Form
Address
AbbVie Inc., 1 N. Waukegan Road, North Chicago, IL 60064
Voice phone
1-866-489-2538

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Submit minimum medical documentation: patient information; copies of insurance cards; relevant medical records (e.g., Parkinson's diagnosis, evidence of levodopa responsiveness) and chart notes; ensure the form is fully completed before fax; additional records may be required by payers. Fax all materials to 1-888-953-2762.

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