Healthcare Provider Details

I. General information

NPI: 1275147357
Provider Name (Legal Business Name): EMILY JO SNEED PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 S HIGHWAY 127
RUSSELL SPRINGS KY
42642-4268
US

IV. Provider business mailing address

308 ROLLING SPRINGS RD
RUSSELL SPRINGS KY
42642-9365
US

V. Phone/Fax

Practice location:
  • Phone: 270-866-3223
  • Fax:
Mailing address:
  • Phone: 270-634-1486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number021588
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: