Healthcare Provider Details

I. General information

NPI: 1497677728
Provider Name (Legal Business Name): JOHN MICHAEL SNYDER R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E SHADOW CREEK LANE
SIOUX FALLS SD
57108
US

IV. Provider business mailing address

400 E SHADOW CREEK LANE
SIOUX FALLS SD
57108
US

V. Phone/Fax

Practice location:
  • Phone: 217-377-7740
  • Fax:
Mailing address:
  • Phone: 217-377-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.033123
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: