Healthcare Provider Details

I. General information

NPI: 1659664266
Provider Name (Legal Business Name): MATTHEW SNYDER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1997 BUFFALO TRL
MORRISTOWN TN
37814-4364
US

IV. Provider business mailing address

1997 BUFFALO TRL
MORRISTOWN TN
37814-4364
US

V. Phone/Fax

Practice location:
  • Phone: 423-254-6597
  • Fax:
Mailing address:
  • Phone: 423-483-1550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000034574
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: