Provider Demographics
NPI:1750392155
Name:SYMBRIA RX SERVICES, LLC
Entity type:Organization
Organization Name:SYMBRIA RX SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:630-981-8150
Mailing Address - Street 1:7125 JANES AVENUE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-2304
Mailing Address - Country:US
Mailing Address - Phone:630-981-8000
Mailing Address - Fax:630-981-8001
Practice Address - Street 1:7125 JANES AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2304
Practice Address - Country:US
Practice Address - Phone:630-981-8000
Practice Address - Fax:630-981-8000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
IL058.0134793336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4192360001Medicare NSC
WI4192360002Medicare PIN
WI4192360002Medicare NSC