Healthcare Provider Details

I. General information

NPI: 1902129893
Provider Name (Legal Business Name): AARON M SNYDER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2010
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 E 5TH ST
BLOOMSBURG PA
17815-2205
US

IV. Provider business mailing address

133 E FIFTH ST
BLOOMSBURG PA
17815
US

V. Phone/Fax

Practice location:
  • Phone: 570-784-1469
  • Fax:
Mailing address:
  • Phone: 570-784-1469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP042260L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: