Rubin Chemists

50+ years of combined experience

Give us a chance, we will show you the difference

Fully stocked with all your pharmacy needs

Lowest Prices

Guaranteed accuracy and efficiency

Prescriptions Filled Quickly

FAST, FREE Delivery & Pickup

New / Transfer Patient Information form


Personal Information
First Name:	Last Name:
Date of Birth:	Gender: Male Female
Mobile:	Phone:
Street Address:
City:	State:

Zip:	Email:
Allergies:

Insurance Information
Cardholder: Yes No
Policy Id:	RX BIN:

RX GROUP:	RX PCN:

MEDICARE ID:	Insurance Name:

Transferring Pharmacy Information
Name of the Pharmacy:

Phone:
I hear by authorizing New Haven Pharmacy to access my medical records to fill my prescriptions or to get the transfer from my existing pharmacy.

Free Delivery & Pick Up

We make sure you never have to wait long for your prescriptions. We pride ourselves on our FAST and FRIENDLY service.

Call on: 718-493-8833
Blister Packing

Blister packaging pre-packages a patient’s medications for a full week by time of day (morning, lunch, supper, bedtime) in order to provide the safe delivery of prescribed drugs to our clients.
Monthly Monitioring

Need monthly monitioring? Count on us, one of our friendly staff will call you every month to see how you are doing and to discuss with you.
OTC Medications

We Sell OTC Medications, Vitamins, Surgical Supplies, Blood pressure Monitors and Diabetic supplies. Cosmetics, Greeting Cards, Gifts, Snacks and Health & Beauty needs
Questions

Please call us so that we can visit your place and explain in person.

Call on: 718-493-8833