MEDICARE: CARRIE ANNE SNELLING RPH

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	03325264	OH
2	1835P1300X	Psychiatric Pharmacist	03325264	OH

General Provider Information

NPI Number	:	1922637305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE ANNE SNELLING RPH

Provider Business Mailing Address
First Line	:	1608 SUNNINGTON GROVE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-6001
Country	:	US
Telephone Number	:	513-649-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1608 SUNNINGTON GROVE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-6001
Country	:	US
Telephone Number	:	513-649-1030
Fax Number	:

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

Provider Enumeration Date	:	04/07/2020
Last Update Date	:	04/07/2020

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