Drug Information
Drug	Potaba
Program Contact Info / Application Submission
Program	Compassionate Drug Program
Company	Glenwood & Western Medical
Address	Glenwood LLC 111 Cedar Lane Englewood, NJ 07631
Phone	800-542-0772 ext 1
Fax	201-529-0250
Program Details
Details	Up to a 90-day supply is sent to the doctor's office. The doctor/doctor's office must contact the company to arrange refills. If the patient stops taking the medication for more than 3 months, then a new application is needed.
Program Requirements
Information	The doctor must fill out a section, sign the application and attach a copy of the DEA or State License number. The patient must fill out a section, sign the application and attach proof of income.
Details	Proof of Income NOT required
Delivery of Medication
Delivery Options	Can NOT be delivered directly to the doctor
Application Process
App Process	The doctor/doctor's office should call for an application. The application is faxed to the doctor's office. The completed application must be faxed or mailed from the doctor's office. The doctor is notified of acceptance or denial. The decision is made within 5-7 business days. The medication is shipped the same day.
New Applications	Doctors can NOT apply directly to the program Can NOT apply for a new application via fax Can NOT apply for a new application via mail
Refills	Doctors can NOT apply for refills
Re-Applications	Doctors can NOT apply for Re-Applications
Eligibility
Eligibility	This is an informal program; decisions are made on a case-by-case basis. The company limits to only 20 patients nationwide at any given time but rarely have 20 people on the program. The company will only accept applications sent in from the doctor.
Other Medications
Other  Medications  available in  this program	Potaba - (Generic: )