1. (a) An outsourcing facility applicant must submit a satisfactorily completed Board-approved application together with the required fee.

   1. (1) New applicants shall provide, at least, the following:

      1. (A) Applicant's full name, all trade or business names used, full business address, telephone number and unique facility identifier;
      2. (B) Type of ownership, e.g. individual, partnership, limited liability company or corporation;

      3. (C) Name(s) of the owner(s) of the applicant, including:

         1. (i) if a person, the name, address, Social Security number and date of birth;
         2. (ii) if other than a person, the name, address, and Social Security number and date of birth of each partner, limited liability company member, or corporate officer and corporate director and the federal employer identification number;
         3. (iii) if a corporation, the State of incorporation; and
         4. (iv) if a publicly traded corporation, the information in (a)(1)(C)(ii) is not required for corporate officers and corporate directors.
      4. (D) Names of designated representatives, facility managers, and, if applicable, pharmacist-in-charge of the applicant, their Social Security numbers and dates of birth;
      5. (E) Evidence of criminal background checks and fingerprinting of the applicant, if a person, and of all of applicant's designated representatives and facility managers;
      6. (F) Proof of licensure by the U.S. Secretary of Health and Human Services, Food and Drug Administration, and, if applicable, by the state where the applicant is located (home state); and
      7. (G) Upon the Board's written request, a list of all dispensers for whom the outsourcing facility provides services at such facility.
   2. (2) Renewal applicants shall provide those items listed above.
   3. (3) Any other information the Board deems necessary to protect the public health and safety.
2. (b) The Board may use an outside agency, such as a National Association of Boards of Pharmacy (NABP), at its discretion, to inspect outsourcing facilities.

Added at 32 Ok Reg 1233, eff 8-27-15