Healthcare Provider Details

I. General information

NPI: 1801400080
Provider Name (Legal Business Name): ALICIA DAWN SNYDER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 W MACARTHUR DR
WEBB CITY MO
64870-2103
US

IV. Provider business mailing address

1011 W MACARTHUR DR
WEBB CITY MO
64870-2103
US

V. Phone/Fax

Practice location:
  • Phone: 417-673-6758
  • Fax: 417-673-2418
Mailing address:
  • Phone: 417-673-6758
  • Fax: 417-673-2418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2016044375
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: