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NoviXus Pharmacy Services PO Box 8004 Novi MI 48376-8004 Mail Order Enrollment Form Please complete and mail this form with all prescriptions. The State of Michigan s Mail Order Provider Enrollment as Simple as 1-2-3 This Mail Service Enrollment Form is only necessary for first time orders including dependents who have been added since the last order or changing current information. To start your Mail Service Benefit follow these steps Step 1 En.

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