Provider Demographics
NPI:1225558695
Name:SYNERGY PHARMACY SOLUTIONS, INC.
Entity Type:Organization
Organization Name:SYNERGY PHARMACY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:661-716-2682
Mailing Address - Street 1:2110 TRUXTUN AVE # 400
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3703
Mailing Address - Country:US
Mailing Address - Phone:661-716-2682
Mailing Address - Fax:
Practice Address - Street 1:2110 TRUXTUN AVE # 400
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3703
Practice Address - Country:US
Practice Address - Phone:661-716-2682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center