Healthcare Provider Details

I. General information

NPI: 1346556958
Provider Name (Legal Business Name): AMANDA KAYE SNYDER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 S SCALES ST WALGREENS PHARMACY
REIDSVILLE NC
27320-5023
US

IV. Provider business mailing address

603 S SCALES ST WALGREENS PHARMACY
REIDSVILLE NC
27320-5023
US

V. Phone/Fax

Practice location:
  • Phone: 336-349-2120
  • Fax:
Mailing address:
  • Phone: 336-349-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21390
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: