MEDICARE: BRIAN HOWARD SNYDER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP035488L	PA

General Provider Information

NPI Number	:	1306480959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN HOWARD SNYDER

Provider Business Mailing Address
First Line	:	503 HIRAM RD
Second Line	:
City	:	PLYMOUTH MEETING
State	:	PA
Zip	:	19462-1271
Country	:	US
Telephone Number	:	610-659-8088
Fax Number	:	215-228-9099

Provider Business Practice Location Address
First Line	:	1300 W LEHIGH AVE STE 102
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19132-2760
Country	:	US
Telephone Number	:	610-659-8088
Fax Number	:	215-228-9099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2019
Last Update Date	:	11/06/2019

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