Healthcare Provider Details

I. General information

NPI: 1568045227
Provider Name (Legal Business Name): VIRGINIA KATHERINE SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 S MAIN ST
MARION OH
43302-5006
US

IV. Provider business mailing address

332 S MAIN ST
MARION OH
43302-5006
US

V. Phone/Fax

Practice location:
  • Phone: 740-382-0650
  • Fax: 740-223-7566
Mailing address:
  • Phone: 740-382-0650
  • Fax: 740-223-7566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number09200192
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: