Notification of Changes for Business Entity
General Information
Business Entity Name:	PHARMACY DATA MANAGEMENT, INC.
Incorporation / Formation Date:	04/16/1984
FEIN:	34-1435943
Ohio License Number:	41788
NPN:	15987517
DBA / Trade Name:
State of Domicile:	OH
County:	MAHONING
Business Address
Address 1:	1170 E. WESTERN RESERVE ROAD
Address 2:
City:	POLAND
State:	OH
Zip:	44514
Phone:	330-757-0724
Fax:
Business Web Site Address:	WWW.PDMI.COM
Business Email Address:	EKOMAR@PDMI.COM
Mailing Address
Address 1:	1170 E. WESTERN RESERVE ROAD
Address 2:
City:	POLAND
State:	OH
Zip:	44514
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	YES	Old Business Entity Name:	PHARMACY BENEFITDIRECT
New DBA/Trade Name:	YES	New DBA/Trade Name:	PHARMACY DATA MANAGEMENT, INC.
Amend DBA/Trade Name:	NO	Old DBA/Trade Name:
Add/Delete Producers, Members, Owners, Partners, Officers and/or Directors:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date

Title Business Entities Only
1. Is any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance? (i.e. banking, auto dealer, mortgage company)	NO
2. Has any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance since the filing of the previous CN-65 or the original application?	NO
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement

Submitted By
Submitted By:	ELIZABETH V. KOMAR
Title:	GENERAL COUNSEL AND DIRECTOR OF COMPLIANCE
Phone Number:	330-757-0724
Email Address:	EKOMAR@PDMI.COM