Provider Demographics
NPI:1104650977
Name:SNYDER, SAMANTHA (PHARMD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1252 50TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-3944
Mailing Address - Country:US
Mailing Address - Phone:205-503-1629
Mailing Address - Fax:
Practice Address - Street 1:668 LOMB AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1330
Practice Address - Country:US
Practice Address - Phone:205-786-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist