825 N 90th Street, Omaha, NE 68114 | HOURS: Monday - Thursday: 8:30 a.m. - 6:00 p.m. | Friday: 8:30 a.m. - 5:00 p.m. | Closed Sunday and Saturday
Holiday Hours:
December 24th: Closing at 2:00PM
December 25th: CLOSED
January 1st: CLOSED

New Patient

We would love the opportunity to serve as your trusted prescription provider.
Please fill out the form below and we will take it from here!

First Name

Last Name

Address

City

State

Zip Code

Email Address

Phone Number

Birth Date (XX/XX/XXXX)

Alternate Contact Name

Alternate Contact Phone Number

Allergies

Optional Prescription Information

Auto Refill My Scripts

Send Text Notifications

Send Email Notifications

Previous Current Pharmacy Name

Previous Current Pharmacy Phone Number

Rx Number

Medication Name and Strength

Rx Number

Medication Name and Strength

Rx Number

Medication Name and Strength

Rx Number

Medication Name and Strength

Message to Pharmacist

Your trusted partner in personalized care: Experience our family owned and operated concierge pharmacy services.

Site Navigation

Contact Us

ViaRx
825 N 90th Street, Omaha, NE 68114
(402) 614-6363 - (402) 505-4397

RPH Clock-In Time Clock Login