Important: New Pharmacy Vendors Effective 10-1-2014

 

Elixir- Pharmacy Benefit Manager

Main Customer Service Phone Number: 1-844-222-5584

Main Prior Authorization Fax Number: 1-877-503-7231

Website: www.envisionrx.com

 

Pharmacy Billing Information:

Line(s) of   Business

BIN

PCN

Commercial/Exchange

009893

ROIRX

Medicaid/Healthy MI

610342

ROIRX

 

Orchard Pharmaceutical Services – Mail Order Vendor thru Elixir– (Commercial Only)

Main Customer Service Phone Number: 1-866-909-5170

Provider Fax Number: 1-866-909-5171

Website: www.orchardrx.com

 

Diplomat Specialty Pharmacy – Specialty Medication Provider

Main Customer Service Phone Number: 1-877-977-9118

Provider Fax Number: 1-800-550-6272

Website: www.diplomat.is

 

J&B Medical Supply – Diabetic Supply Provider

Main Customer Service Phone Number: 1-844-236-7933

Provider Fax Number: 1-800-737-0012

Website: www.jandbmedical.com