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General NPI Number Information
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NPI Number | 1356984181
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Entity Type | Organization
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Legal Business Name | SYMBRIA RX SERVICES GREAT LAKES-EAST, LLC
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 23350 MERCANTILE RD
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City | BEACHWOOD
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State | OH
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Zip | 44122-5921
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Country | US
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Telephone | 216-514-4944
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Fax |
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Provider Business Mailing Address
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Address Line | 28100 TORCH PKWY STE 600
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City | WARRENVILLE
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State | IL
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Zip | 60555-4030
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF PHARMACY
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Name | DEREK BROWN
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Credential | PHARMD
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Telephone | 630-981-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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