Please enter your information below to JOIN NOW. A representative of Buygility will contact you soon with a membership number and start you on your way to savings!About Your PharmacyPharmacy Name*Pharmacy Shipping Address* Street Address Address Line 2 City State ZIP / Postal Code Pharmacy Phone*Contact Name* First Last Title/Position*Contact Email* Website AddressPlease enter N/A if no website.Member Primary Service (Choose one below)*Closed Door PharmacyPharmacyProvider DEA#*Enter provider's DEA number associated with the facility's shipping address. If not readily available, enter PENDING.Provider NPI# and/or HIN#If you don't have a NPI# or HIN#, leave blank. If you have one and don't have the number handy, enter PENDING.Your information will be used to populate the necessary forms for membership which include the Buygility GPO Membership form, the Premier Inc. GPO Membership form, and a standard GPO Declaration form (which is sent by us to multiple suppliers to get GPO pricing for you on the items those suppliers sell).Forms will be emailed to you for electronic signature. You should receive an email from DocuSign within a few minutes.I'm human.CommentsThis field is for validation purposes and should be left unchanged.