Healthcare Provider Details

I. General information

NPI: 1952931941
Provider Name (Legal Business Name): ADAM JAMES SNYDER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2020
Last Update Date: 01/19/2020
Certification Date: 01/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

378 MARKETPLACE PKWY
DAWSONVILLE GA
30534-7266
US

IV. Provider business mailing address

378 MARKETPLACE PKWY
DAWSONVILLE GA
30534-7266
US

V. Phone/Fax

Practice location:
  • Phone: 470-375-1995
  • Fax: 470-375-1996
Mailing address:
  • Phone: 470-375-1995
  • Fax: 470-375-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH024248
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: