Virginia's Medical Equipment Supplier Permit and Nonresident Registration

Virginia regulates DME suppliers by product. Its Drug Control Act makes it "unlawful for any person to act as a medical equipment supplier ... in this Commonwealth without a valid unrevoked permit issued by the Board" of Pharmacy (Va. Code 54.1-3435.2(A)), and it defines a medical equipment supplier as anyone "engaged in the delivery to the ultimate consumer, pursuant to the lawful order of a practitioner, of hypodermic syringes and needles, medicinal oxygen, Schedule VI controlled devices, those Schedule VI controlled substances with no medicinal properties that are used for the operation and cleaning of medical equipment, solutions for peritoneal dialysis, and sterile water or saline for irrigation" (54.1-3401). A supplier outside Virginia that ships those items to Virginia consumers registers as a nonresident medical equipment supplier instead (54.1-3435.3:1).

Which suppliers fall under Virginia's definition?

The list is specific, so start with your catalog. You are in scope if you deliver, on a prescriber's order, any of:

• hypodermic syringes and needles;
• medicinal oxygen;
• Schedule VI controlled devices, which in practice means prescription-only devices;
• Schedule VI substances with no medicinal properties used to operate or clean medical equipment;
• peritoneal dialysis solutions;
• sterile water or saline for irrigation.

A supplier of items outside that list, such as off-the-shelf braces sold without a prescription, may need no Virginia permit at all. A supplier of CPAP, oxygen or other prescription devices almost certainly does. Distribution of Schedule VI drugs or devices, needles and syringes, or medicinal oxygen under the permit "is limited to delivery to the ultimate user upon lawful order by a prescriber" (54.1-3435.2(C)), and the only prescription drugs a supplier may handle under the permit are the non-medicinal operating and cleaning substances, peritoneal dialysis solutions, and sterile water and saline (54.1-3435.2(B)).

What does the in-state permit cost?

Under 18VAC110-20-20, as of October 2026:

The same rule says "engaging in activities requiring a permit or registration after the expiration date ... shall be grounds for disciplinary action," and that a facility that stops operating and wants to resume "shall apply for a new permit."

Will the Board inspect an in-state location?

Under 18VAC110-20-680, "A medical equipment supplier's location shall be inspected by the board prior to engaging in business." The rule then requires:

1. a clean, sanitary location with temperature control for any Schedule VI drug or device;
2. needles, syringes and Schedule VI drugs kept off open display, and Schedule VI devices only where "responsible parties" can supervise them;
3. a valid practitioner's order before dispensing, kept "for a period of two years from date of last dispensing," with the original allowed at a central office if retrievable within 48 hours;
4. a dispensing record (patient, item and quantity, date) kept on the premises for two years;
5. a defined procedure for transferring orders between suppliers, with "VOID" and "TRANSFER" annotations or the equivalent in an automated system.

Those order rules sit alongside Medicare's own documentation requirements, which White Glove Medical Billing covers in DME billing is a documentation business.

How does the nonresident registration work?

"Any person located outside the Commonwealth other than a nonresident pharmacy registered pursuant to § 54.1-3434.1 that ships, mails, or delivers to a consumer in the Commonwealth" any of the listed items on a prescriber's order "shall be registered with the Board as a nonresident medical equipment supplier" (54.1-3435.3:1(A)). The key terms:

• Renewal: "by March 1 of each year," with the fee the Board sets by regulation.
• Changes: notify the Board "within 30 days of any substantive change in the information previously submitted."
• Home-state license: maintain "a valid, unexpired license, permit, or registration in the state in which it is located, if required by the resident state," and furnish proof at application and renewal. If the home state has no such license, "the applicant shall furnish proof that it meets the minimum statutory and regulatory requirements for medical equipment suppliers in the Commonwealth" (54.1-3435.3:1(B)).
• Records: keep records of Virginia distribution separately retrievable and provide them to the Board or State Police "within seven days of receipt of such request" (54.1-3435.3:1(C)).

The Board's in-state fee rule (18VAC110-20-20) and its nonresident fee rule for wholesalers and manufacturers (18VAC110-50-20) do not list a nonresident medical equipment supplier fee that we could find, so confirm the current amount with the Board before you apply. A nonresident pharmacy already registered in Virginia is outside this section.

What if my home state has no license?

Then the home-state proof becomes a compliance showing. A Texas-based supplier, for example, operates in a state with no general DME supplier license (see does Texas require a DME license?), so its Virginia registration needs evidence that it meets Virginia's medical equipment supplier requirements: order handling, records, storage and the rest of 18VAC110-20-680. We build that evidence file from your policies and records.

When do Virginia credentials renew?

The in-state permit is due by February 28, and the nonresident registration by March 1, every year. Both sit in the same winter window as North Carolina's December 31 permits, which is one reason suppliers shipping to the Southeast like a single calendar. See a renewal calendar for state DME licenses.

How do we help with Virginia?

Virginia is a standard state at $699 (pricing). We check your catalog against the statutory list, prepare the in-state permit application and inspection readiness or the nonresident registration with your home-state proof, and track the February 28 or March 1 renewal. Your owner or an officer signs, and you pay the Board. We can send the signed application for you; any Board online account stays in your name. See the Virginia state page and licensing as an out-of-state DME supplier.