Retailer Information

Retailers interested in the DMD Pharmaceuticals® line of over-the-counter (OTC) pharmaceuticals and dietary supplements such as ephedrine, and their attractive profit margins should contact their local candy and tobacco wholesaler or novelty distributor to find out if they are an authorized DMD distributor. If you need a name of an authorized DMD distributor, please fill out and submit the Retailer Request Form below, and a sales representative will contact you with the requested information.

Learn how you can begin allowing your customers to buy EPHED® and other DMD Pharmaceuticals® products in your store.

Retailer Request Form

Retailer Name *
Corporate Name
(if applicable)
Address
City
State *
Zip
Phone Number *
(xxx-xxx-xxxx)
Fax (xxx-xxx-xxxx)
Email Address *
Contact Person *
Title
Number of Stores
States Store Located
(hold down CTRL key to select more than one)
Candy & Tobacco Wholesaler Name *
Novelty Distributor Name
Currently carrying DMD products?
If yes, Name of Distributor
Other Energy Products (brands) sold by retailer
Distributor(s) for products mentioned above
What prompted retailer to contact DMD?
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