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General NPI Number Information
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NPI Number | 1538529698
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Entity Type | Organization
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Legal Business Name | POLARIS SPECIALTY PHARMACY LLC
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 206 NW PLAZA DR STE 206
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City | RIVERSIDE
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State | MO
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Zip | 64150-9574
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Country | US
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Telephone | 314-549-6300
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Fax | 816-897-4105
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Provider Business Mailing Address
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Address Line | 2900 NW 60 STREET
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309
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Country | US
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Telephone | 800-589-9747
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Fax | 954-923-9261
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Authorized Official
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Title or Position | CEO
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Name | DAVID ROMBRO
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Credential |
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Telephone | 800-589-9747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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