Healthcare Provider Details

I. General information

NPI: 1427298009
Provider Name (Legal Business Name): SNAP4KIDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 W 21ST ST UNIT G-2/706
NORFOLK VA
23517-1950
US

IV. Provider business mailing address

520 W 21ST ST UNIT G-2/706
NORFOLK VA
23517-1950
US

V. Phone/Fax

Practice location:
  • Phone: 757-855-0306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: PAM FLOYD
Title or Position: FOUNDER
Credential:
Phone: 757-855-0306