Healthcare Provider Details

I. General information

NPI: 1437500089
Provider Name (Legal Business Name): MICHELLE JULIEMARIE SNYDER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 06/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3036 EMRICK BLVD
BETHLEHEM PA
18020-8018
US

IV. Provider business mailing address

276 SUSQUEHANNA TRL
ALLENTOWN PA
18104-8571
US

V. Phone/Fax

Practice location:
  • Phone: 877-734-5250
  • Fax:
Mailing address:
  • Phone: 484-358-2391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP040790L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: