NPIMap

Organization Active NPI

Symbria RX Services, LLC

  • Community/Retail Pharmacy
  • Wilmette, IL
National Provider Identifier
1285915561
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054.017170 Issued in IL
Legal business name
SYMBRIA RX SERVICES, LLC
Practice address
2801 Old Glenview Road
Suite 228
Wilmette, IL 60091-3001
Phone
(630) 413-5843
Fax
(847) 256-9583
NPI assigned
Aug 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jay Mandra, PHARMD
Title
Director of Pharmacy
Phone
(630) 981-8091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054.017170 IL Primary

Addresses

Primary practice location

2801 Old Glenview Road
Suite 228
Wilmette, IL 60091-3001

Mailing address

2801 Old Glenview Road
Suite 228
Wilmette, IL 60091-3001
Phone (630) 413-5843

Other identifiers 1

IdentifierTypeStateIssuer
2131873OtherPK

Other names 1

  • Alliance Pharmacy Services Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131028000173 IL Part B Supplier - Mass Immunization (Roster Biller Only) 5597877829 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodridge, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 6

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379462400000",
    "number": "1285915561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 OLD GLENVIEW ROAD",
            "address_2": "SUITE 228",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600913001",
            "telephone_number": "630-413-5843",
            "fax_number": "847-256-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 OLD GLENVIEW ROAD",
            "address_2": "SUITE 228",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600913001",
            "telephone_number": "630-413-5843",
            "fax_number": "847-256-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYMBRIA RX SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-31",
        "last_updated": "2013-09-18",
        "status": "A",
        "authorized_official_last_name": "MANDRA",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "630-981-8091",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.017170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131873",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alliance Pharmacy Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wilmette, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.