Healthcare Provider Details

I. General information

NPI: 1346556081
Provider Name (Legal Business Name): ROBERT SNYDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2010
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date: 02/26/2024
Reactivation Date: 05/21/2024

III. Provider practice location address

24 SUMMIT PARK DR STE 101
PITTSBURGH PA
15275-1104
US

IV. Provider business mailing address

24 SUMMIT PARK DR STE 101
PITTSBURGH PA
15275-1104
US

V. Phone/Fax

Practice location:
  • Phone: 855-726-8479
  • Fax: 855-246-3986
Mailing address:
  • Phone: 855-726-8479
  • Fax: 855-246-3986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP443613
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: