# SYNERGEN RX LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Synergen Rx
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811550528
- **Authorized official:** JONATHAN PERSONIUS (OWNER)
- **Authorized official phone:** (478) 951-6066

## Contact information

- **Practice address:** 3990 FLOWERS RD STE 530, DORAVILLE, GA 30360-3195
- **Practice address phone:** (404) 585-7517
- **Practice address fax:** (404) 900-9209
- **Mailing address:** 3990 FLOWERS RD STE 530, DORAVILLE, GA 30360-3195
- **Mailing address phone:** (404) 585-7517
- **Mailing address fax:** (404) 900-9209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336H0001X | Home Infusion Therapy Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/18/2019
- **Last updated:** 06/18/2021