Healthcare Provider Details

I. General information

NPI: 1164840880
Provider Name (Legal Business Name): RICHARD SNYDER RRT, RPSGT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RICK SNYDER RRT, RPSGT

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E INDIAN SCHOOL RD
PHOENIX AZ
85012-1839
US

IV. Provider business mailing address

30283 N WOODPIGEON DR
SAN TAN VALLEY AZ
85143-1274
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5551
  • Fax:
Mailing address:
  • Phone: 438-231-8524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279S1500X
TaxonomySNF/Subacute Care Registered Respiratory Therapist
License NumberL0005652
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License NumberZ0000113
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number16080
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number15852
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: