Healthcare Provider Details

I. General information

NPI: 1104650977
Provider Name (Legal Business Name): SAMANTHA SNYDER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

668 LOMB AVE SW
BIRMINGHAM AL
35211-1330
US

IV. Provider business mailing address

1252 50TH ST S
BIRMINGHAM AL
35222-3944
US

V. Phone/Fax

Practice location:
  • Phone: 205-786-4481
  • Fax:
Mailing address:
  • Phone: 205-503-1629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23717
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: