Provider Demographics
NPI:1093172991
Name:SYMBRIA RX SERVICES GREAT PLAINS, LLC
Entity Type:Organization
Organization Name:SYMBRIA RX SERVICES GREAT PLAINS, LLC
Other - Org Name:SYMBRIA RX SERVICES GREAT PLAINS
Other - Org Type:Doing Business As
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:306-981-8150
Mailing Address - Street 1:28100 TORCH PKWY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3938
Mailing Address - Country:US
Mailing Address - Phone:630-413-5800
Mailing Address - Fax:630-413-5801
Practice Address - Street 1:348 NW CAPITAL DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4723
Practice Address - Country:US
Practice Address - Phone:630-981-8023
Practice Address - Fax:630-981-8123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20160018793336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy