# SYMBRIA RX GREAT LAKES SOUTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Symbria Rx Great Lakes South 1
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902569676
- **Authorized official:** DEREK BROWN (VICE PRESIDENT OF PHARMACY)
- **Authorized official phone:** (630) 981-8150

## Contact information

- **Practice address:** 307 23RD STREET EXT, STE 164, SHARPSBURG, PA 15215-2821
- **Practice address phone:** (724) 545-1600
- **Mailing address:** 7125 JANES AVE STE 300, WOODRIDGE, IL 60517-2304
- **Mailing address phone:** (630) 413-5800
- **Mailing address fax:** (630) 413-5801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/19/2021
- **Last updated:** 11/19/2025