Classic Pharmacy

Please submit this form so your prescription can be filled by Classic Pharmacy.  A new prescription may need to be obtained from the Wagner College Center for Health and Wellness office.  IMPORTANT:  You must send a copy of your medical insurance card to classicrx@gmail.com and studenthealthservice@wagner.edu

Classic Pharmacy

This form will provide Wagner College and Classic Pharmacy with your Insurance information in order to fill your prescription.
  • Supply Insurance Company Prescription Card Information.
  • Every Prescription Card has a BIN #. If there is not a BIN # then it is probably not your Prescription Card.
  • Classic Pharmacy: 718-727-0022
  • Signature required upon delivery
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.

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