Wholesale Data Upload Account Registration

* Denotes required field

Company Information

Company Name* Phone*
Street Address* Fax*
City* Web URL
Zip Code*

DEA and License Information

DEA Number
 This facility does not have a DEA number
Ohio Drug Distributor License Number*
  • An Ohio licensed drug distributor may report sales and suspicious orders on behalf of another licensed drug distributor owned and operated by that distributor.
  • After registration, an Ohio drug distributor can add more relationships under the Manage Relationships section.
  • Once entered, an Ohio drug distributor may submit sales and suspicious orders on behalf of the facilities listed using this account.

Primary Contact Information

Name* Email Address*
Direct Phone*

Secondary Contact Information

Name Email Address
Direct Phone

Login Information

Username* Password**
  Confirm Password

Having trouble creating a strong password? Click here to generate one.


Enable Two Step Authentication

Adds a second layer of security to your account so that when you attempt to log in, the system will provide you with an authentication code via email, which you will be prompted to enter.