Healthcare Provider Details

I. General information

NPI: 1982936142
Provider Name (Legal Business Name): PAUL JOSEPH SNYDER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL JOSEPH SNYDER RPH

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3083 MILLER RD
FLINT MI
48507-1353
US

IV. Provider business mailing address

G3083 MILLER RD
FLINT MI
48507-1353
US

V. Phone/Fax

Practice location:
  • Phone: 810-238-0489
  • Fax: 810-235-8118
Mailing address:
  • Phone: 810-238-0489
  • Fax: 810-235-8118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302021367
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: