Healthcare Provider Details

I. General information

NPI: 1194124057
Provider Name (Legal Business Name): KAREN SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2014
Last Update Date: 08/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 DAVIDSONVILLE RD
CROFTON MD
21114-1317
US

IV. Provider business mailing address

10432 WHITE CT
LAUREL MD
20723-5709
US

V. Phone/Fax

Practice location:
  • Phone: 410-721-4783
  • Fax:
Mailing address:
  • Phone: 301-483-6340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12707
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: