Apply to change information on an existing wholesale distributor facility

If you need to relocate or change ownership of your wholesale distributor facility, you can apply here.

Bureau of Health Professions Licensure

The Details of Apply to change information on an existing wholesale distributor facility

What you need for Apply to change information on an existing wholesale distributor facility

For relocation

  • You will need to fill out the Application for Relocation of a Wholesale Distributor, found below.
    • You need to return previously issued permits with the application.
  • You need to pay the relocation fee, listed below.
  • You need to submit an official blueprint or certified architectural plans, drawn to scale.
  • Signed affidavit
    • The owner or corporate officer must be sign the affidavit on the application, and have it witnessed by a Notary Public.

For transfer of ownership

  • You will need to fill out the Application for Transfer of Ownership of a Wholesale Distributor, found below.
    • You need to return previously issued Board permits with the application.
  • Attach an official bill of sale or minutes of meeting.
    • Include a certified copy of asset transfer.
  • If the new owner is a corporation:
    • If the corporation is incorporated in the Commonwealth:
      • Attach a copy of the corporation's Articles of Organization, signed and sealed by the Secretary of State.
    • If the corporation in incorporated in another state:
      • Attach a copy of the corporation's Foreign Corporation Certificate, signed and sealed by the Secretary of State pursuant to M.G.L. c. 181, § 4.
    • The name and address of each officer and director of the corporation and the position held.
    • The d/b/a name of the corporation.
    • If the corporation is not publicly owned:
      • The total amount and type of stock issued to each stockholder.
      • The names and addresses of said stockholder(s).
    • The corporation's outstanding permit and Massachusetts controlled substances registration.
  • A payment of the fee.
  • Signed affidavit
    • The owner or corporate officer must be sign the affidavit on the application, and have it witnessed by a Notary Public.

Fees for Apply to change information on an existing wholesale distributor facility

  • You can pay the fee(s) with either a certified check, money order, or personal check. Make it payable to the Commonwealth of Massachusetts
  • The fee(s) are non-refundable
Name Fee Unit
Application for relocation of a wholesale distributor $900 each
Application for transfer of ownership of a wholesale distributor $900 each
Handling charge for returned checks $23 each

How to apply Apply to change information on an existing wholesale distributor facility

If you are relocating

  1. Download the Application for Relocation of a Wholesale Distributor, found below.
  2. Fill out the application
    • Include any and all attachments
  3. Include payment of all applicable fees as checks or money orders
  4. Mail application to:

Board of Registration in Pharmacy
239 Causeway St.
Suite 200, 2nd Floor
Boston, MA 02114

 

If you are transferring ownership

  1. Download the Application for Transfer of Ownership of a Wholesale Distributor, found below.
  2. Fill out the application
    • Include any and all attachments
  3. Include payment of all applicable fees as checks or money orders
  4. Mail application to:

Board of Registration in Pharmacy
239 Causeway St.
Suite 200, 2nd Floor
Boston, MA 02114

 

Downloads for Apply to change information on an existing wholesale distributor facility

Contact for Apply to change information on an existing wholesale distributor facility

Address
239 Causeway St., 5th Floor, Suite 500, Boston, MA 02114
Fax
(617) 973-0980

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