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Patient Assistance Information

Niche Pharmaceuticals Sample Program

580 Commerce St, Suite 100
Southlake, TX 76092
Phone : (800)677-0355
Fax: (817)421-2778
> This program is for Healthcare Professionals Only. Insurance requirements have not been specified. Income requirements for the patient have not been disclosed. Patients must be a US resident.
Who Can Apply
> Doctor or hospital must call for an application to be faxed to them.
> Patients must inform their doctor that they are in need of assistance. Doctors must complete a section, sign and attach a prescription.
> Not specified
Ship To
> Not specified
> Resources for HEALTHCARE PROFESSIONAL ONLY. The Doctor must contact the program to place an order.
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
Mag-Tab SR tablet