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AdventHealth Rx Plus Pharmacy fax number

(833) 896-0650

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Non-Specialty Prior Authorization

Used for: Submitting non-specialty formulary exception and prior authorization requests; faxing prescriptions (with cover sheet) as part of prescription processing.

Fax destination details

Department
Non-Specialty Prior Authorization
Purpose
Submitting non-specialty formulary exception and prior authorization requests; faxing prescriptions (with cover sheet) as part of prescription processing.
Form
Non-Specialty Formulary Exception/Prior Authorization Request Form — Non-Specialty Formulary Exception/Prior Authorization Request Form
Address
5050 Wesley Road, Suite 110, Apopka, FL 32712
Voice phone
+1-866-943-4535

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Fax the completed form to 1-833-896-0650; include patient and prescriber information and any required documentation per the form.

Official form instructions are published as a downloadable file on the organization's website.

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