Healthcare Provider Details

I. General information

NPI: 1154492163
Provider Name (Legal Business Name): SNIDERS DISCOUNT PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15582 HIGHWAY 280 STE 100
CHELSEA AL
35043-8361
US

IV. Provider business mailing address

PO BOX 262
CHELSEA AL
35043-0262
US

V. Phone/Fax

Practice location:
  • Phone: 205-678-3899
  • Fax: 205-678-3339
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112881
License Number StateAL

VIII. Authorized Official

Name: DOUGLAS SNIDER
Title or Position: OWNER
Credential:
Phone: 205-678-3899