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Request an Cardinal Health at-Home Account
*Business Type:
*Legal Company Name:
*Legal Company Address:
Legal Company Address 2:
*Federal Tax ID:
*Billing Address:
Billing Address 2:
*City:
*State:
*Zip Code:
*Contact Name:
*Title:
*Phone: Ext:
*Email:
*Confirm Email:
*Preferred Contact Method:
*Years in Business:
*Estimated Monthly Medical Supply Spend:
*Current Medical Supply Distributor:
Comments:

  • Cardinal Health at-Home is the leading provider of medical supplies direct to the home. We aspire to be a trusted partner in the delivery of home medical supplies to Home Medical Equipment Provides and their customers. Please complete the below web form to submit your application for a new account. In order to uphold the standards which have led to our broad selection as primary vendor, we will only set up new accounts which stand to gain the most from our value added approach to distribution.
  • If you are a current account holder needing to setup additional locations or lines of business, please contact your sales rep or indicate same in the Contact Us web form.

  • Please provide the following information, and a Cardinal Health at-Home Representative will contact you to set up an account.
  • *Denotes a required field.

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