Healthcare Provider Details

I. General information

NPI: 1275457954
Provider Name (Legal Business Name): MICHAEL SNOW PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 CALVERT AVE
ALEXANDRIA VA
22301-1007
US

IV. Provider business mailing address

312 CALVERT AVE
ALEXANDRIA VA
22301-1007
US

V. Phone/Fax

Practice location:
  • Phone: 804-647-4812
  • Fax:
Mailing address:
  • Phone: 804-647-4812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202211540
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: