Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with New York State Department of Health – Uninsured Care Programs (ADAP) before sending sensitive documents. FaxFlow is not affiliated with this organization.

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New York State Department of Health – Uninsured Care Programs (ADAP) fax number

(518) 459-7429

Uninsured Care Programs (ADAP)

Used for: Pharmacy Enrollment Form submission for ADAP/Uninsured Care Programs

Fax destination details

Department
Uninsured Care Programs (ADAP)
Purpose
Pharmacy Enrollment Form submission for ADAP/Uninsured Care Programs
Form
Independent Pharmacy Enrollment Form — Pharmacy Enrollment Form
Address
Empire Station, P.O. Box 2052, Albany, NY 12220-0052
Voice phone
1-800-542-2437

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.

PLEASE PRINT CLEARLY. Email the completed form to adap.admin@health.ny.gov OR fax to (518) 459-7429

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

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