=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194124057
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN SNYDER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2014
-----------------------------------------------------
Last Update Date | 08/17/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2003 DAVIDSONVILLE RD
-----------------------------------------------------
City | CROFTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21114-1317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-721-4783
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10432 WHITE CT
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20723-5709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-483-6340
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 12707
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------