Tek Service Pros Web Pay

Have your billing statement available prior to completing this form.

If you do not know your account balance, please contact:

Bremo Pharmacies Business Office & Training Center
804-285-8055
Customer Bill Pay

You have the option to pay your house account balance online. Use the form below to complete credit card payment. Please note that account balances can not be verified through this form.
Full Name on Account*

First NameLast Name
Account Location*
Account #
Full Name of Payer (if different from above)

First NameLast Name
Address of payer if different than payee

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Phone Number of Payer*

Area CodePhone Number
E-mail*
Statement Date*
Upload Statement Receipt (optional)

Browse Files

Cancelof
Notes

Payment*

USDPayment Amount

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Customer Bill Pay