To start you would need:
- State licence
- NPI number
- NABP/NCPDP
- DEA Registration (some states also require a separate controlled substances permit)
- Medicare PTAN (For DMEPOS billing) <-- This is a giant pain. Just so you're aware.
- State Medicaid provider number
It would also be wise to Incorporate your business.
- Occupancy permit from your city/county/state
- Sales tax permit
- Work Comp insurance
- Business liability insurance (most third parties require 3m/1m liability limits)
- Federal EIN
- State Tax ID number
- Contract with a primary wholesaler (Amerisource, Cardinal, McKesson)
- Contract with a buying group (not necessary, but recommended)
- Contract with a PSAO (most buying groups have one)
- Some third parties require separate contracts outside of what your PSAO offers
That should be most of it, although I wouldn't be surprised if I missed something.
Your two main expenses for starting up are going to be your software license (plan about 20-25k for a decent one, then about $500 per month thereafter) and your inventory. Your inventory should roughly equal your 30 day sales. Going forward, your biggest expense will be payroll. Plan for about 1.5x salary to cover payroll taxes and federal withholdings. And be prepared to write a lot of checks, as it seems every organization will have a random bill for you (my favorite is Express Scripts requiring you to certify with a random company in order to process their claims. $150 for literally no purpose).
Good luck to you!
