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General NPI Number Information
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NPI Number | 1912672072
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Entity Type | Individual
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Provider Name | JEFF SNELLEN II PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 1718 CATLIN DR
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City | BARNHART
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State | MO
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Zip | 63012-1277
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Country | US
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Telephone | 636-461-1347
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Fax |
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Provider Business Mailing Address
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Address Line | 506 BACON AVE
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City | WEBSTER GROVES
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State | MO
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Zip | 63119-1513
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Country | US
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Telephone | 314-452-3896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2021031024
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License Number State | MO
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