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| Medical/Surgical Supplies & Equipment |
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| Order Forms |
| For your convenience, order forms for medical and surgical supplies and equipment are listed below in a PDF format. Simply print the form(s) you need, then complete and fax them to us at 515.278.6714. If you have questions or problems, please call our office at 515.278.4930. DEA 222 Form Instructions
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On-Call Assistance
Phones answered 24/7,
even on holidays.
515.278.4930
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Member: Independent
Medical Co-op Inc.
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First Medical, Inc.
Address: 8515 Douglas Ave. Ste. 23 | Urbandale, Iowa 50322
Telephone: 515.278.4930 | Fax: 515.278.6714
Email: firstmedical@qwest.net |
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