MEDICARE: EMILY JO SNEED PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	021588	KY

General Provider Information

NPI Number	:	1275147357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY JO SNEED PHARMD

Provider Business Mailing Address
First Line	:	308 ROLLING SPRINGS RD
Second Line	:
City	:	RUSSELL SPRINGS
State	:	KY
Zip	:	42642-9365
Country	:	US
Telephone Number	:	270-634-1486
Fax Number	:

Provider Business Practice Location Address
First Line	:	181 S HIGHWAY 127
Second Line	:
City	:	RUSSELL SPRINGS
State	:	KY
Zip	:	42642-4268
Country	:	US
Telephone Number	:	270-866-3223
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2020
Last Update Date	:	09/04/2020

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