Main Street Drug

204 North Main Street Charles City, Iowa 50616

(641) 228-3519

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Main Street Drug

204 North Main Street Charles City, Iowa 50616

(641) 228-3519
Closes at {{closingHours}}
Directions
Online Refills
Services

Change Store

Prescription Transfer Request

Fill out this form to request to have your prescription transferred to Main Street Drug.
This form will be delivered via secure fax, and we will notify you when your prescription is ready to pickup.

Patient Information

First name *

Last name *

Phone Number *

Email Address *

Date of Birth *

Prescription Information

Existing Pharmacy Name *

Existing Pharmacy Phone Number *

Prescription # *

Prescription Name *

Comments

* Indicates required field