User account

This site is for Health Care Providers with a valid DEA Registration in the (our market) states. Mohawk Medical can ship controlled substances only to the address on the DEA Registration.

Account information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Professional Information

Account Name: *

Your business or organization's name. The content of this field is kept private and will not be shown publicly.

Business Phone Number: *

(area code and number with no spaces - ex. 1112223333) The content of this field is kept private and will not be shown publicly.

Alternate Phone Number:

(area code and number with no spaces - ex. 1112223333) The content of this field is kept private and will not be shown publicly.

Fax Number:

(area code and number with no spaces - ex. 1112223333) The content of this field is kept private and will not be shown publicly.

Contact Person: *

Who should we contact about orders? The content of this field is kept private and will not be shown publicly.

DEA number: *

The content of this field is kept private and will not be shown publicly.