Healthcare Provider Details

I. General information

NPI: 1821090341
Provider Name (Legal Business Name): SNIDER DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 06/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 TAYLORSVILLE RD
BLOOMFIELD KY
40008
US

IV. Provider business mailing address

PO BOX 188
BLOOMFIELD KY
40008-0188
US

V. Phone/Fax

Practice location:
  • Phone: 502-252-8242
  • Fax: 502-252-7556
Mailing address:
  • Phone: 502-252-8242
  • Fax: 502-252-7556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP00365
License Number StateKY

VIII. Authorized Official

Name: GEORGE SNIDER
Title or Position: PRESIDENT
Credential: RPH
Phone: 502-252-8242