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Account Type

Customer Type*

Personal Details

Name*

Surnames*

Collegiate Number

NIF*

Password

Email*

Password*

Repeat Password*

Company Details

Position*

Pharmacy Name*

Company CIF*

Pharmacy Head Name*

Pharmacy Phone*

Pharmacy Email*

Contact Person in Administration*

DIR Code Accounting Office*

DIR Code Managing Agency*

DIR Code Processing Unit*

Billing Address

Street*

Post Code*

City*

Country*

Billing Address

Same as billing address

Street*

Post Code*

City*

Country*

Licenses

Cooperative Details

Cooperator Code*

Main cooperative you want to operate with*

Client Groups

Grupos de cliente

Bank Details

Payment Method

IBAN Code

I have read and accept the Terms and Conditions and Privacy Policy *

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We are the laboratory
of the cooperative

years
of experience

95%

of pharmacies
trust us

6th

laboratory
in unit sales

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