A pharmaceutical system and method of operation in which a single remote professional provides pharmaceutical care and oversight of multiple local pharmacies. A control location is connected through an electronic network to one or more individual pharmacies, each of which may be located at a different physical site. Each individual pharmacy includes one or more drug preparation areas, and one or more self-service or staffed customer terminals. A drug preparation area includes a robot, which is adapted to prepare prescriptions or other items, and which is connected by a pneumatic delivery system to one or more customer terminals within the pharmacy.