Provider Demographics
NPI:1033491477
Name:CZECK, NATHANIEL SNYDER (PHARMD)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:SNYDER
Last Name:CZECK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6670 PLEASANTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-1035
Mailing Address - Country:US
Mailing Address - Phone:330-719-3466
Mailing Address - Fax:
Practice Address - Street 1:50 COLUMBIA AVE W
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3181
Practice Address - Country:US
Practice Address - Phone:269-969-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2015-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist