Become A Distributor

Distributor Inquiry Form

Does your business sell to professional healthcare provider facilities like hospitals, surgery centers, nursing homes, dental practices, or doctor’s offices? NDC is a master wholesale organization offering an array of services to support healthcare distributors.

NDC only sells to established resellers. Residential addresses are not accepted. State tax exemptions/resale certificates will be required for every state where your company ships merchandise.
Note: This is not an application.

First Name*

Last Name*

Company*

Referred by a Manufacturer?

Phone*

Fax

Email*

Street*

City*

State/Province*

Zip*

Website*

Year Established*

Number of Sales Personnel

Annual Revenue

Top Three Vendors*

Primary Market:

Minority Status:

Store Front:

*Required